What’s Better: A Dental Implant or a Bridge?

In case of partial tooth loss, dental bridges or implants can be installed. Each method has its pros and cons. Let's talk about the advantages and disadvantages of these popular orthopedic constructions.

Advantages and Disadvantages of Dental Bridges and Implants

Bridge prosthetics involve the installation of a bridge, that is, a structure of crowns fused together, on supporting teeth. Dental implantation involves the installation of crowns on implants, metal posts implanted into the jawbone that function as tooth roots. These methods are noticeably different from each other. The final choice between them is made by the dentist, but the patient's opinion is taken into account. The doctor also considers the clinical picture.

Dental Bridges

A bridge prosthesis is installed on abutment teeth, which need to be prepped first. This construction is typically used to restore two or three adjacent teeth. However, the length of the bridge can be longer, up to five crowns. In this case, additional supports might be needed, sometimes implants are used for this purpose.

The lifespan of a bridge construction depends on the material it is made from, the loads it withstands, and proper oral care. On average, this period is 4-10 years.

If a tooth fell out or was removed 3-5 years ago, bone grafting is likely not needed.

Advantages:

• natural appearance;
• complete restoration of chewing function;
• quick adaptation – usually no more than a day;
• no discomfort during wear and no speech issues;
• usually requires only three clinic visits for installation;
• minimal list of contraindications.

There are also disadvantages.

1. In the absence of teeth that can be used as supports, implants will still be needed.
2. If there are supporting teeth, they will need to be prepped, which might require nerve removal. This is a painful procedure, and if the teeth were healthy, it will worsen their condition. The risk of caries increases, and sensitivity rises.
3. A space forms between the bridge and the gum where food particles get stuck and bacterial plaque accumulates.
4. The gap between the prosthesis and the gum is noticeable, which is a significant aesthetic downside.
5. Bridge prostheses are not installed in cases of severe periodontitis or periodontosis. Other contraindications include the absence of posterior molars, osteoporosis, and jawbone atrophy.

Implants

Implants are artificial roots made of metal. Usually, they are made of titanium and other lightweight, strong, and biocompatible materials. First, they are implanted into the jawbone, then loaded with crowns.

Implantation allows for the restoration of both a single tooth and an entire row of teeth. Moreover, it's not necessary to implant a separate root for each tooth; fewer implants can be used.

The lifespan of artificial roots is on average 20 years. Some manufacturers offer a lifetime warranty on their implants. The lifespan of the crowns installed on them is shorter and depends on the material and how well the patient cares for their oral cavity. The most durable crowns are made of metal and zirconium dioxide.

Advantages:

• prevention of jawbone atrophy;
• even distribution of chewing load;
• preservation of the integrity of neighboring teeth;
• long service life;
• compatibility with different types of crowns – an artificial tooth row can be created to look impeccably natural.

Disadvantages:

• surgical intervention is required;
• there is a risk of rejection, although, if the surgeon is highly qualified and uses premium implants, this risk is minimal;
• the cost is higher compared to installing a bridge prosthesis;
• the installation period is lengthy, especially when using a two-stage protocol, where 4-6 months pass between implanting the posts and loading them with permanent crowns;
• an additional bone grafting surgery might be needed.

Comparative characteristics of methods for restoring dentition

When is it better to choose a bridge?

The table above shows that implantation has more advantages compared to installing a bridge prosthesis. However, using a bridge is a reliable and inexpensive method. It is often chosen with a limited budget and in the presence of absolute contraindications to implantation, such as:

• blood clotting disorders;
• autoimmune, oncological diseases;
• serious structural changes in bone tissue;
• lupus;
• tuberculosis;
• allergy to drugs used for local anesthesia.

A bridge prosthesis can be used if several teeth located next to each other need to be restored. This option is more suitable for the restoration of chewing units. In the frontal zone, it may not provide the necessary level of aesthetics.

At the same time, the patient should understand that the lifespan of a bridge usually does not exceed 10 years – and that is in the best case. There is also a risk of bone atrophy under the prosthesis. It is important that the root system under the teeth used as supports is healthy. Otherwise, it will not withstand the load caused by the installation of the orthopedic construction. This will lead to caries, loosening of the roots, and tooth mobility. In this case, implantation will become the only possible solution.

When is it better to install an implant?

Implantation allows for the restoration of a single tooth or an entire row of teeth without the risk of jawbone atrophy. The likelihood of complications is very low. There is no need to prep teeth for supports, and restoration can be performed in cases of partial and complete edentulism – the absence of teeth. Therefore, dentists mostly recommend using implants. This option is more expensive than installing a bridge prosthesis, but it provides better results in terms of aesthetics, functionality, and durability. Implantation should only be avoided in the case of a seriously limited budget and the presence of absolute contraindications to this method of tooth row restoration. However, one must be prepared for the fact that the integration of the artificial root can take 4-6 months, sometimes longer. A metal post can only be implanted if there is enough bone tissue volume. If the jawbone is thin or low, it will need to be augmented first. This requires surgery, which also takes time. Common indications for the use of implants include:

• partial or complete edentulism;
• the need to remove a tooth;
• destruction of the crown part by 60% or more, serious root defects.

What is better for front and chewing teeth?

If teeth are missing in the frontal zone, it is better to use implants. This option is more preferable from an aesthetic point of view – provided that crowns are used that look beautiful and natural. The gum tissue will maintain a healthy appearance. The jawbone after implantation will not deteriorate or recede. If you need to restore chewing teeth, you can install implants or a dental bridge. The disadvantage of the first option is that you have to wait for the artificial roots to integrate. Installing a bridge allows for a quicker solution to the problem, provided that there are teeth that can be used as supports. They will need to be prepped, which is a painful procedure.

Dental clinic AESTHETE is located in Dubai (UAE), Bluewaters Island. We invite clients who need tooth restoration. The clinic employs experienced orthopedic dentists who use modern restoration techniques. They have the necessary tools, materials, and equipment at their disposal. Contact us – and you will get excellent results. The administrator will answer your questions, tell you about the services and their prices, help you choose a suitable time to visit the doctor, and make an appointment.