4.

Types of bridges, criteria of abutment tooth

There are two types of bridges, the conventional and the sophisticated dental bridge.
The types of conventional bridges are:
1. Rigid Fixed Bridge

The rigid fixed bridge is a bridge that replaces the loss of one or more teeth in a row, supported
by one or more abutment teeth at each end of the diastema (at the mesial and distal)
There should be no movement of the abutment teeth
Indication:
o For loss of 1 to 4 teeth in a row
o Where the masticatory force is normal or large
o Small abutment teeth
o If one of the abutment teeth is loose without periodontal disturbances nor post
periodontal therapy
Advantages:
o Has a wide indication
o Has the best splinting effect
Disadvantages:
o Lifting forces may be produced, especially with long spans when the bolus is at one of
the ends of the bridge
o Deflection may also be produced when the bolus is at the middle of the span
Criteria of abutment teeth
o The position and inclination of the abutment teeth should be parallel, or if vital made
parallel, without harming the pulp
Types of rigid fixed bridges based on the materials used:
o All acrylic rigid fixed bridge
Indication
As a temporary bridge
Loss of anterior teeth on young patients
No allergies to acrylic
Low masticatory force, for example on open bites
The advantages and disadvantages are related to acrylics physical properties
o All metal rigid fixed bridge
Indication:
For tooth loss that doesnt have esthetic needs
Short abutment teeth
Short or small prosthesis space
The advantages and disadvantages are related to the physical properties of
metals
o All porcelain rigid fixed bridge
Rarely used because the indication is limited
Indication:
Loss of one anterior tooth
Less than normal masticatory force
The sizes of the abutment teeth are larger than normal
Advantage: esthetically pleasing
Disadvantage:
Brittle
Hard to make
o Combination
Metal acrylic rigid fixed bridge
Metal porcelain rigid fixed bridge
Has a wide indication because it can replace missing teeth in all regions
It is strong and esthetic
Semi fixed bridge

o A semi fixed bridge is a bridge replacing one or two teeth supported by one or more
abutment teeth at both edges of the diastema (mesial and distal)
o Produces limited individual movement of the abutment teeth during function
Produced due to non rigid connector
o Indication:
Loss of one or two teeth where one of the abutment teeth is vital and tipped
more than 20
Loss of two teeth with an intermediate abutment
Normal or low masticatory force
Normal shape and size of abutment teeth
o Construction
The non rigid connector is at the distal of the diastema
This is to avoid the key being pulled out of the connector due to the anterior
component of force (ACF) during occlusion
o Advantages:
The non rigid connectors will neutralize lifting forces happening to the
abutment teeth and vertical forces will be spread and distributed to all
abutment teeth
The preparation doesnt harm the pulp
Incremental cementation procedure
o Disadvantages:
It is relatively hard to make hard to be precise
It is relatively expensive
Has less splinting effect
There is a possibility of fracture at the key
Cantilever bridge

o The cantilever bridge is a type of fixed bridge that replaces the loss of one tooth and is
supported by one or more abutment teeth only at one side (mesial/distal)
o Indication: (limited, usually on)
Loss of upper second incisors, with the canines as abutment teeth
Loss of the second premolars with a short span, with the first molars as the
abutment teeth
Loss of the lower third molars, with the first and second molars as the abutment
teeth, especially if the opposing tooth is present
Low masticatory force (open bite) without bad habits
The abutment teeths shape and size should accommodate the factors of
retention and resistance, and also able to accept lifting and rotational forces
The bone support should be adequate: crown:root ratio: 2:3
o Disadvantages:
The presence of lifting forces may cause:
Destruction of the periodontal tissues causing the teeth to be loose
The mucosa under the pontic to be compressed/irritated that may lead
to diseases
The presence of palatolabial rotation may cause:
The abutment teeth to be rotated masticatory load will be uneven,
impaction and retention of food periodontal disease and caries
o Advantages:
Tooth preparation is only on 1 tooth (if only one abutment tooth is used)
Abutment teeth do not need to be parallel to each other
o This type of bridge is rarely used due to its disadvantages
4. Combination
These bridges are a combination of conventional fixed bridges
Examples:
o Loss of both upper second incisors with a central diastema between the first incisors
combination of two rigid fixed bridges
o Loss of the second incisor and second premolar of the same region rigid fixed bridge
with a cantilever bridge
o Loss of the first premolar and the first molar semi fixed bridge with rigid fixed bridge
5. Modification
The modification bridge is modified due to certain conditions
Spring bridge
o A type of fixed bridge with a long connector, where the retainer isnt located at the ends
of the diastema
o Indication;
Loss of one anterior tooth with the abutment tooth being far from the diastema
Large central diastema
Loss of one tooth with multiple diastema
Low to normal masticatory forces
No deep palatal bite
o Dsadvantages:
Same as the cantilever spring where there is presence of the lifting forces and
deflection
Connector easily breaks
It is hard to clean under the connector
Is not too comfortable
o Advantages:
In cases with multiple diastema, it is more esthetically pleasing because it looks
real/natural
It can rehabilitate tooth crowns far from the location of tooth loss
Telescopic bridge
o The telescopic fixed bridge is a bridge that uses telescopic retainer on one of the teeth
o Indication:
For loss of one or two teeth with one vital abutment tooth
o Construction:
The telescopic bridge uses a rigid connector
The difference is the fabrication of the telescopic crown and coping
The preparation of the tipped tooth is according to the tooth axis, but the
coping on the mesial side is parallel to the tooth axis of other abutment teeth
Periodontal bridge (sanitary bridge/hygiene bridge)
o The periodontal bridge is a type of fixed bridge where the design prioritizes the
cleanliness and the health of the periodontal tissues
o Construction:
The retainers cervical margin is supragingival
The pontic is a sanitary pontic and the material is high polished
o Application:
The periodontal bridge is temporary, so it can be removed to ease control of the
periodontal tissues
Immediate bridge
o The immediate bridge is a type of fixed bridge that is used after tooth extraction
o Aim: estethics and to fasten healing
o Construction:
Conical pontic type
o Therapy procedure
The abutment teeth are prepared and an impression should be taken to make
the working model
On the working model, the tooth to be extracted is removed and the ridge is
shaped according to the expected extraction result
The bridge is made according to the working model that has been manipulated
After extraction, the bridge is placed, the cervical edge of the pontic should
enter the tooth socket
After the resorbtion process has finished and the residual ridge is normal, the
pontic base is corrected so that the bridge can be used permanently