Is A Dental Implant Better Than A Bridge?

Is A Dental Implant Better Than A Bridge?

Posted by Dental Didactics CE on Aug 19th 2022

How a Dental Bridge Replaces a Tooth:

If a tooth is decayed or fractured and cannot be saved it must be extracted by a dental surgeon. Following healing of the extraction site a dentist can replace the missing tooth with a permanent dental bridge that is cemented in place. The bridge, in its simplest form, is fabricated using metal alloys and porcelain materials. A false tooth (or "pontic") is attached to crowns placed on the two teeth adjacent to the extraction site. The bridge is cemented in place and does not come out. The disadvantages of fixed cemented dental bridges include:

  • Need to remove enamel from adjacent teeth to allow crowns to be placed
  • Potential damage to dental pulps (nerves) of the teeth drilled on for crowns
  • Potential need for root canals on crowned teeth that hold the false tooth
  • Increased difficulty of oral hygiene around bridge
  • Inability to floss around pontic
  • Food impaction under the pontic
  • Added chewing stress on the adjacent teeth which support the pontic

Advantages of a Dental Implant Over a Bridge:

An alternate choice to replace a missing tooth is a dental implant. An implant is a specialized titanium screw which is inserted into the extraction site which supports a screw-retained permanent crown. Advantages of an implant include:

  • No need to remove enamel from adjacent teeth
  • Little chance of pulp (nerve) damage to adjacent teeth
  • Implant functions independently and takes up stress of chewing
  • No additional stress on adjacent teeth
  • Ability to floss around implant and perform better oral hygiene
  • No potential sensitivity in implant
  • Implant and crown cannot decay
  • No risk of tooth fracture on adjacent teeth from stresses on bridge
  • Preserves bone on ridge where extraction occurred

Sometimes an Implant is Not Recommended:

Although they have many advantages over conventional bridges there are situations where an implant may not be the ideal solution for tooth replacement:

  • Insufficient bone to support an implant
  • History of periodontal disease or diabetes that would put implant at risk
  • Bone disease or treatment with bisphosphonate drugs that could cause osteonecrosis
  • Patient is a poor surgical risk (bone disease, bleeding disorders, etc.)
  • Patient needs immediate replacement of tooth (implants can take 6 months to a year to heal and have crown placed)
  • Poor bone anatomy in area (low sinus, narrow ridge, etc)
  • Patient age: many elderly patients do not want to wait months for extraction site healing, implant placement, implant healing, etc.
  • Patient does not want an invasive surgical procedure to place implant
  • Bone grafting may be needed to support the implant
  • Other teeth are also missing and all teeth could be replaced with a removable partial denture

The following dental CE courses address implant advantages and disadvantages: