Dental implants vs dental bridges

Last Updated: 10.01.2024

Author: George Ghidrai, MD  

Most often, dental implants offer the best clinical solution for replacing missing teeth.

In this article, we will compare traditional dental bridges supported by natural teeth to dental implant restorations. You will discover the pros and cons of each type of reconstruction and the most important factors to consider when deciding between implants and dental bridges.

You can either get a dental bridge or rely on dental implants to replace lost teeth.

Moreover, if you have a badly damaged tooth, you can either restore it with a dental crown or extract it and place an implant.

In the past, when implants were not available, these decisions were easier to make. Nowadays, dental implants offer a highly efficient and reliable option; however, you should discuss the advantages and disadvantages of both procedures with your dentist before making your final decision.

a. Replacing lost teeth

Most dentists agree that implants are preferable to fixed bridges in case of missing teeth, assuming the patient has adequate financial ability and time for the entire treatment.

However, there are times when the advantages of a fixed bridge may suggest that a fixed bridge would be preferable to using implants.

First, let's review some general considerations about both procedures:

• Dental implants

  Dental implants are metal devices surgically inserted into the jawbone to replace one or more missing teeth. Implants can support a dental prosthesis such as a crown, bridge, or removable denture.

  

  First, a surgical procedure is required to place the dental implant inside the jawbone. Dental implants form an intimate bond with the bone through a biological process called osseointegration.

  A variable amount of healing time is required for osseointegration (3 to 6 months), although some approaches, such as Same-day Dental Implants aim to shorten this time.

  After the healing time, an abutment is attached to the implant. The abutment will hold the dental prosthesis (in this case, a dental bridge).

  

  implant-supported dental bridge

• Dental bridge

  A dental bridge is a fixed dental prosthesis that replaces one or several missing teeth by permanently joining an artificial tooth to adjacent teeth.

  

  Dental bridges require proper preparation of the adjacent teeth. It is the most significant disadvantage of bridges as it leads to the loss of large amounts of healthy tooth tissue and sometimes even tooth devitalization and endodontic treatment.

Deciding between implants and bridges

It would be best if you always made the decision after consulting with your dentist. They will inform you about the different solutions, advantages, and disadvantages of each, the difference in costs, and any risks and potential complications.

That being said, here are the most important factors to consider:

• Cost

  The cost of dental implants is usually higher than a dental bridge; this is especially true if the gap has 2 or 3 missing teeth, in which case you will need more than one implant to restore it.

  Moreover, dental implants may need adjunctive procedures (such as sinus lift or bone graft) to increase the amount of bone that supports the implants; these procedures will add to the final cost.

• Completion time

  A dental bridge can be completed in two sessions; dental implants generally need more time (3 to 6 months) to fuse with the bone after the surgical procedure.

  Nevertheless, in some circumstances, an implant can be placed immediately after a tooth extraction. Still, even in this event, many practitioners will prefer to place temporary restorations for a particular time.

• Aesthetics

  What about aesthetics? There isn't always a simple answer; typically, dental implants provide the most pleasing results, but a properly constructed ceramic bridge can also be highly aesthetic.

  There are times when a cosmetic dentist may prefer a porcelain bridge over an implant because it can give him more control over eliminating the small gaps between teeth that may look unattractive if a dental implant is used.

• Protecting the adjacent teeth

  Here, dental implants have a significant advantage as they preserve natural tooth tissue by avoiding the need to prepare adjacent teeth. In addition, dental implants offer independent support to crowns and bridges, thus not putting any strain on other teeth.

  

  single tooth gap: if a traditional dental bridge is designed, the preparation of the adjacent teeth is required

  
  

  

  single tooth gap: if an implant-supported crown is manufactured, the adjacent teeth remain untouched

  Dental bridges, on the other hand, rely on natural teeth to perform the function of support. After preparation, your natural teeth remain beneath the bridge; hence, the remaining tooth structure continues to be susceptible to decay and gum disease.

• Maintenance

  Implants are easier to maintain. They can replace teeth individually without affecting other teeth, making regular home care more successful. You can effectively brush and floss around an implant just like your natural tooth.

  Dental bridges involve at least three crowns connected together to fill the missing tooth's space. This design creates challenges when brushing and flossing, requiring extra oral hygiene instructions.

• Durability

  A dental implant, if correctly done, rarely will need replacement. Dental implants are made of solid metal (titanium) and are very resistant to decay and gum problems. The lifespan for the implant-supported bridge is 10 to 15 years.

  On the other hand, the average life of a dental bridge is approximately 10 years.

When might dental bridges be considered the preferred solution?

These situations will be evaluated case-by-case; you should always decide after consulting your dentist.

• If you already have crowns on either side of the missing tooth, then placing a 3-unit bridge may be preferable because it would avoid any surgeries, and the result is that the three teeth would all match.
• If the neighboring teeth have large fillings or extensive structural damage and need crowns in the future.
• If you are a heavy smoker, have untreated periodontal disease, or have a large bony defect.
• If you do not have the budget to have an implant placed or cannot return to the clinic for the definitive implant restoration.

b. Restoring a damaged tooth

When a large part of a tooth's original crown structure has been lost, you can either restore the tooth with a dental crown (left image) or extract the tooth and place an implant. The implant will then support the dental crown (right image).

The decision should be based on:

• the amount of tooth structure remaining

• the type of occlusion (or bite)

• financial considerations

• patient desire to keep the natural tooth

• patient acceptance of other needed procedures to retain the tooth, such as a root canal and sometimes the placement of a post and core.

  What is a Post and Core?

  • A post and core is a prosthetic device utilized when inadequate tooth structure remains to support a traditional restoration or an artificial crown.

    

    The post is a small rod, usually metal, inserted into the tooth's root space and protruding from the root a couple of millimeters. The post is then used to hold the core and the dental crown in place.

It is a good idea to save the tooth whenever the procedure is possible.

However, when the tooth crown is severely damaged, mainly when the tooth is fractured below the gumline, removing the tooth and placing a dental implant is the only solution.

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