Dental Bridge vs. Dental Implant - Pros and Cons - Which is better? in Turkey, Istanbul

What is a dental bridge?

A dental bridge is a type of fixed denture used to replace one or more missing teeth with artificial ones. It is also known as a traditional fixed partial denture or a three-unit bridge. Just as a road bridge uses two pillars for support, a dental bridge uses the intact teeth on either side of the gap where the missing teeth were (these teeth are reduced in size) to support a new tooth or teeth in the gap.

A dental bridge consists of two or more crowns that support an artificial tooth (or pontic), which replaces the missing tooth. These crowns are placed on the abutment teeth on either side of the gap.

What is a dental implant?

A dental implant is an artificial tooth root that is surgically placed into the jawbone to replace a missing tooth or teeth. It is designed to function like a natural tooth. Typically shaped like a screw or cylinder, it is made almost entirely of biocompatible titanium, which the body readily accepts.

Implants also feature an internal thread or post cavity, allowing for the attachment of various components. These components provide a stable foundation for the long-term support of crowns, bridges, or dentures.

Dental bridge vs. Dental implant

Features	Dental Bridge	Dental İmplant
Support	Uses neighboring teeth on either side of the missing tooth.	Directly supported by the jawbone, it acts as an artificial tooth root.
Tooth Preparation	It requires significant re-duction of the neighbo-ring (support) teeth.	Does not require preparation or damage to healthy neighboring teeth.
Bone	The bridge does not rep-lace the missing root structure. Increased risk of bone loss over time. Does not stimulate bone growth.	Acts as an artificial root, fuses with bone (osseointegration).Acts as an artificial root, fuses with bone (osseointegration). It prevents/reduces bone loss and helps maintain bone density and stimulates bone growth. Sufficient bone is required for the imp-lant; sometimes bone grafting may be required.
Lifespan	Usually around 7-10 ye-ars. High maintenance; may need to be replaced in 5-10 years.	It is a long-lasting and permanent solution. It can last a lifetime under appropriate care and conditions.
Cleaning	More difficult to clean, under the bridge and around the edges must be cleaned with special tools. Requires frequent clea-ning to prevent bacterial accumulation.	Brushed and cleaned like natural teeth, no special tools required. Easy to care for.
Cost	In the beginning it is usually more economical.	It is usually more expensive in the be-ginning.
Process	It is usually completed in a shorter time (a few we-eks).	It takes longer to complete (generally 3-4 months of recovery time is required, inc-luding the process of integration with the cuticle)
Surgery	It is usually not a major surgical procedure.	Placement in the jawbone requires a surgical procedure.
Success/Risks	Increased likelihood of caries and endodontic treatment (root canal tre-atment) on support teeth. Increased risk of tooth loss due to stress on the support teeth. If one part fails, the entire restoration can fail, often resulting in the loss of the supporting tooth.	It has a high success rate. Active gum disease, insufficient bone or certain medical conditions/medications may affect implant success or make imp-lant placement inappropriate.
Function and Aesthetics	It can look natural. Chewing forces are trans-ferred to the deciduous teeth.	They look, feel, and function like natural teeth. It can improve chewing ability and pati-ent satisfaction.

Types of dental bridges

• Traditional fixed dental bridge (fixed partial denture/3-unit bridge):
• This is the most common conventional treatment for replacing a single missing tooth.
• It uses adjacent (neighboring) teeth on either side of the missing tooth gap as support.
• The support teeth are significantly reduced or prepared so that crowns can be placed on them. Healthy teeth or teeth with small restorations may be damaged by this preparation.
• The artificial tooth (pontic) and the crowns on the support teeth are combined in-to a single unit and cemented to the support teeth.
• In cases where aesthetics are required, subgingival edges may be required.
• They can be made of metal, ceramic, or a combination of both.
• Cleaning may require special tools and is more difficult.
• Stress on the supporting teeth can increase the risk of caries, endodontic treat-ment (root canal treatment), or tooth loss. If part of the bridge fails, the entire res-toration may fail, often with the loss of the supporting tooth.
• In young patients, it may require multiple replacements over a lifetime.

Cantilever bridges:

• Unlike a traditional bridge, a cantilever bridge is held in place only by a dental crown cemented to an abutment tooth.
• It is cemented to the tooth on only one side of the missing tooth.
• Usually used on anterior teeth (risky on posterior teeth due to high forces).
• Requires less tooth cutting. Only one of the adjacent teeth needs to be prepared.
• High risk of breakage or loosening due to one-sided support.
• Not recommended for back teeth.

Maryland bridge (Resin-bonded bridge)

• Maryland bridges are made of porcelain, porcelain fused to metal, or plastic teeth and gums supported by a metal or porcelain frame.
• Metal or porcelain wings are bonded to the back surface of neighboring teeth.
• It is a minimally invasive method that does not require tooth cutting.
• It is applied quickly and painlessly.
• Metal-backed Maryland is stronger, but the wings may be visible.
• Fiberglass/porcelain Maryland is more aesthetic and suitable for front teeth.
• The adhesive may loosen over time.
• Not used in areas that require a lot of force.

Implant-supported dental bridges:

• Implant-supported dental bridges are used when more than one tooth is mis-sing, and, unlike traditional bridges, they use dental implants placed in the jawbone for support instead of natural teeth.
• Such bridges are placed on implants and are supported directly from the bone.
• Unlike traditional bridges, instead of using neighboring natural teeth, they are supported by dental implants placed on either side or below the gap.
• Bone loss can still occur in artificial tooth gaps (pontic spaces), but bone is pre-served where implants are placed.

Removable dental bridge:

• It can be used to replace one or more missing teeth.
• It attaches to the teeth on both sides of the cavity with clips.
• It can be inserted and removed by the patient.
• It may have metal retainers, usually mounted on an acrylic base, or a cast metal frame.

How does a dental bridge work?

The working principle of a dental bridge includes the following steps:

Identifying the support teeth:

The adjacent teeth on either side of the missing tooth gap are used as abutment teeth for the bridge.

Preparation of the support teeth:

In a conventional fixed bridge, these support teeth need to be significantly reduced or prepared. This preparation is for the placement of crowns and requires the removal of tooth structure (0.5-1.5 mm abrasion).

Impressions are taken using digital or traditional methods. The temporary bridge is worn until the actual bridge is prepared in the laboratory.

Placement:

This composite structure is placed over the prepared support teeth and permanently bonded to the teeth with cement (a special adhesive). In this way, the bridge closes the gap and replaces the missing tooth.

A bite test is performed.

The gum fit is checked.

Transfer of forces:

During chewing, the forces on the pontic are not transferred directly to the bone but to the adjacent teeth supporting the bridge. This creates additional stress on the support-ing teeth.

How long does a dental bridge last?

The table below shows the average lifespan of dental bridges by type and the factors that can be used to increase the lifespan.

Type of Bridge	Average Lifespan	Factors Affecting Longevity
Traditional Bridge	10-15 years	Material (metal-ceramic lasts longer) Oral hygiene Teeth grinding (bruxism)
Maryland (Adhesive) Bridge	5-10 years	Bond strength Chewing forces (weaker than traditional)
Implant-Supported Bridge	15-25+ years	Implant success rate Bone health Maintenance
Cantilever Bridge	5-10 years	Single-side support (higher failure risk)
Removable Bridge	5-8 years	Wear & tear on clasps Bone shrinkage over time

Benefits of dental bridges

• Traditional fixed bridges (three-unit bridges) can usually be completed in a shorter time compared to implants (usually within a few weeks).
• Dental bridges are generally less costly than dental implants.
• Placing a traditional bridge is not a major surgical procedure like placing an implant. It involves preparing the adjacent teeth but does not require a surgical step like placing the implant in the bone.
• Bridges can look very natural. Their aesthetic appeal is increasing with advances in materials and techniques.
• In some cases, a traditional fixed bridge may be the most suitable option, especially when adjacent teeth already have large restorations or when bone deficiency prevents implant placement.
• It can also be more easily applied to patients with certain health problems, such as diabetes and high blood pressure.

Disadvantages of dental bridges

Although dental bridges have some advantages in replacing missing teeth, they also have significant disadvantages.

• The adjacent teeth to be used as support need to be significantly reduced or “eroded”. This preparation leads to permanent loss of healthy tooth structure. Teeth with small or no restorations are damaged by this preparation and are at increased risk.
• Instead of transferring chewing forces directly to the jawbone, the bridge transfers these forces to the supporting teeth. This increased stress and preparation increase the risk of caries, root decay, and endodontic treatment (root canal treatment) on the supporting teeth. The stress and preparation on the supporting teeth can lead to failure and loss of these teeth over time.
• A dental bridge does not replace the root structure of the missing tooth. Therefore, there is an increased risk of bone loss over time in the jawbone below the gap. This bone loss can contribute to reduced bone density and an unaesthetic appearance (an older appearance).
• Bridges may loosen, break, or require replacement for other reasons over time.
• Cleaning under bridges and around the supporting teeth is more difficult and often requires special cleaning instruments, which can increase the buildup of bacterial plaque and caries around the bridge margins.
• In aesthetic cases, under-gum edges may be required, but this can increase gingivitis. Bone and gum loss over time can lead to gaps under the bridge, which can impair aesthetics.

How to care for a dental bridge?

• Brush 2 times a day (morning and evening) with a soft-bristle brush.
• Especially clean under the bridge and the gum line.
• Normal dental floss cannot reach under the bridge; use a floss threader or water flosser. An intermediate facial brush is also an effective option.
• Prevent bacterial growth by rinsing with antibacterial mouthwash.
• Denture cleaning tablets are useful for removable bridges.
• Strengthen the support teeth by using fluoride paste.
• Do not chew foods such as ice, hard candy, or nuts with shells with the bridge. Sticky foods such as chewing gum and caramel can dislodge the bridge.
• If you have teeth grinding (bruxism), protect the bridge by using a night plaque (transparent plaque).
• Have scaling and bridge checks every 6 months. Your dentist will check whether the bridge has loosened or if there is decay underneath.
• If the bridge does not fit correctly, consult your dentist immediately.

How much is a dental bridge?

The prices of dental bridges vary depending on the clinic, the country where the clinic is located, and the material used. Average prices (€):

Dental Bridge	Turkey	Germany	Italy	USA
Metal-Ceramic Bridge	250-500	800-1,500	600-1,200	1,000-2,500
Full Ceramic (Zirconium) Bridge	400-800	1,500-3,000	1,000-2,000	2,000-4,500
Maryland Bridge	150-350	500-1,000	400-800	800-1,500
Implant Supported Bridge	1,000-2,000	3,000-6,000	2,500-4,500	4,000-10,000
Removable Bridge	100-300	400-800	300-600	500-1,200

Dental bridge vs implant for front teeth

The anterior teeth are the most aesthetically visible teeth. Therefore, it is of great importance that the restoration look natural and that the gum line and bone level be maintained.

Although bridges may initially look aesthetic, over time, the loss of the underlying bone may cause the gum to recede and gaps to form under the bridge, which may impair the appearance. Since implants prevent bone loss, they can help maintain the gum level better, and the aesthetic result is more permanent.

The front teeth are usually small, and preparing them for a bridge can greatly alter their natural structure. Because the implants do not touch the adjacent teeth, the appearance and health of the existing natural teeth are preserved, which is important for overall smile aesthetics.

While both options can replace missing front teeth, implants are generally the more aesthetically permanent and biologically conservative option in appropriate cases due to their potential to preserve adjacent teeth, help prevent bone loss, and have a longer life span.

For patients who are not suitable for implants (such as those with bone deficiency) or who do not want a surgical procedure, bridges may be a viable option

.

What are implant-supported bridges?

An implant-supported bridge is a type of dental restoration used to replace multiple missing teeth. Unlike traditional bridges, instead of using the natural teeth next to the missing tooth gap as support, it uses dental implants placed in the jawbone as support.

An implant-supported bridge is created by placing titanium posts (implants) in the jawbone instead of the root of the missing teeth and fixing a bridge (a unit of artificial teeth) on these implants. This can be an option in cases where three or more teeth are missing; for example, two implants are placed, and a bridge is attached to these implants to close the gap between them.

There is no need to cut adjacent healthy teeth.

Helps prevent or reduce bone loss.

It has the potential to last longer.

It can look aesthetically natural.

Improves chewing function and comfort.

The initial cost is usually higher.

Implant placement requires a surgical procedure.

Treatment time is longer due to the time required for the implants to heal with the bone.

Frequently Asked Questions

Is a dental bridge permanent?

A dental bridge (traditional fixed partial denture) is often described as a non-removable, i.e., fixed or permanent, restoration. However, this permanence does not usually mean that it will last a lifetime.

Although a dental bridge is called fixed or permanent because it is not removable, it does not provide lifelong permanence and can be used for up to 15 years with proper care. For a long-term solution, an implant is more advantageous.

Can a dental bridge be removed and recemented?

The dental bridge can be removed and reattached, but this should be done in certain circumstances and with care.

Situations in which a dental bridge can be removed:

• When the bridge begins to move.
• Caries develops in the supporting teeth.
• The bridge is cracked or fractured.
• If the color or shape is to be changed.

How to remove a dental bridge:

The dentist removes the bridge with special instruments without weakening the adhesive.

Rebonding the dental bridge:

• If the bridge and supporting teeth are intact, the same bridge is cleaned and bonded with new cement.
• If there is decay or damage, it is treated first.
• If the bridge is broken or has lost its fit, a new one must be made.
• If the bridge falls off, you can get temporary adhesive (dental cement) from the pharmacy, but this is an emergency solution; go to the dentist immediately.

Why does a doctor prefer a bridge over an implant?

This preference often depends on the patient's specific situation, oral health, general health, and other factors.

Here are the conditions and factors that may lead the doctor to favour a bridge over an implant:

Bone insufficiency:

Since implants are placed in the jawbone, adequate bone density and volume are required. If there is bone loss in the area of the missing tooth, additional surgical procedures (such as bone grafting) may be required for implant placement. If bone grafting is not possible or the patient does not prefer it, bone deficiency may prevent implant placement, in which case a traditional bridge may be the only option to provide a stable restoration.

Condition of neighbouring teeth:

If the neighbouring teeth already have major restorations or need crowns due to cracks or decay, it may be more practical to prepare these teeth for bridge support. In this case, the use of teeth that already require treatment may be considered more acceptable than if healthy teeth are sacrificed.

Cost:

The initial cost of conventional bridges is usually lower than implants. The patient's financial situation may be an important factor in the decision-making process.

Duration of treatment:

If the patient needs restoration quickly, a bridge may be preferred.

General health status:

Medical conditions such as certain chronic diseases (such as uncontrolled diabetes), smoking, and long-term bisphosphonate use may increase the risk of implant failure.

Patients with active gum disease are generally not good candidates for implants. In such cases, a bridge may be considered a more appropriate or safer option than an implant, which requires a surgical procedure.

Avoidance of undergoing surgery:

Some patients may wish to avoid surgery or may not be suitable candidates due to the risks of surgery.

What is a single-tooth bridge?

A single tooth bridge or dental bridge is a type of dental restoration used to replace one or more missing teeth, usually by using natural teeth on either side of the gap of the missing tooth as a support.

The traditional bridge used to replace a single missing tooth is often referred to as a three-unit bridge. This nomenclature derives from the following:

• Two crowns placed over the teeth on each side that support the bridge.
• One artificial tooth (pontic) is placed between these two crowns, filling the gap.
• In total, it consists of three units (two crowns, one pontic).

Consult Yakadent Dental and Oral Health Hospital to determine the best option for your needs and oral health.

For more information please contact us.