Dental implants vs dental bridges
To replace lost teeth, you can either get a dental bridge or you can rely on dental implants.
Moreover, if you have a badly damaged tooth, you can either restore it with a dental crown or you can extract the tooth 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 may want to discuss the advantages and disadvantages to both procedures with your dentist before making your final decision.
1. Replacing lost teeth
Most dentists agree that in case of missing teeth, implants are preferable to fixed bridges, assuming that 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 the use of implants.
First, some general considerations about both procedures:
Dental implants are metal devices that are surgically inserted into the jawbone in order to replace one or more missing teeth. Implants can support a dental prosthesis such as a crown, bridge or a 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 true a biologic process called osseointegration.
A variable amount of healing time is required for osseointegration (3 to 6 months) although some approaches (see 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 (crown, bridge, removable denture).
A dental bridge is a fixed dental prosthesis used to replace one or several missing teeth by permanently joining an artificial tooth to adjacent teeth or dental implants.
Dental bridges require proper preparation of the adjacent teeth. It is the biggest 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
You should always make the decision after consulting with your dentist. He or she will inform you about the different solutions, advantages and disadvantages to each, the difference in costs, and any risks and potential complications.
That being said, here are the most important factors to consider:
The cost of dental implants is most of the time higher compared to 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.
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, but even in this event, many practitioners will prefer to place temporary restorations for a certain period of time.
What about aesthetics? There isn't always a simple answer; normally, 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 great advantage as they preserve natural tooth tissue by avoiding the need to prepare adjacent teeth. In addition, dental implants offer independent support to crown 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.
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 space of the missing tooth. This design creates challenges when brushing and flossing so extra oral hygiene instructions are required.
A dental implant, if properly done, rarely will need replacement. Dental implants are made of strong metal (titanium) and they are very resistant to decay and gum problems.
The average life of a dental bridge, on the other hand, is approximately 10 years.
Most of the time dental implants are superior to bridges for replacing missing teeth. But the final solution depends on the patient budget, goals, lifestyle choices, and time restraints.
When could dental bridges be a better solution ?
- 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 large structural damage and need crowns in the future.
- If you are a heavy smoker, have untreated periodontal disease or a large bony defect.
- If you do not have the budget to have an implant placed, or cannot return to the clinic for the restoration of the implant.
2. 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 or you can extract the tooth and place an implant.
Decision should be based on the amount of tooth structure remaining, occlusion, financial considerations, patient desire to keep the natural tooth, and patient acceptance of other needed procedures to retain the tooth (such as root canal and sometimes the placement of a post and core).
Generally, it is a good idea to save the tooth whenever the procedure is possible. However, when the tooth crown is severely damaged, especially when the tooth is fractured below the gumline, removing the tooth and placing a dental implant is the only solution.
this is a case when the tooth can be restored with a post and a dental crown
tooth with advance coronal destructions; extraction and placement of dental implant indicated
Colgate Oral Care Center: Dental Bridge Vs. Implant: Which Is Right For You? by Donna M. Rounsaville, RDH,BS
Your Dentistry Guide: Implants vs Bridges
Last review and update: February 2019