cosmetic & anti-aging dentistry
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Bridges are actually extensions of crowns with artificial replacement teeth attached to "bridge" the space left by missing teeth. These artificial replacements which fill up gaps in the dental arch, supported by crowns on either side, are called pontics.
Bridges are prepared in almost exactly the same way as crowns, except that for bridges, the dentist will have to take alignment even more seriously. The longer the bridge, the less room there is for error. Designing bridges with adequate support is also important as the crowns will have an additional burden of supporting the pontics. Your dentist is likely to spend a lot more time on the study models, planning a suitable course of action and a suitable design for your bridge. Do not rush him.
Like crowns, bridges are usually made from porcelain fused to metal. This material is strong and suits most purposes. However, the metal often shows through around the gum margin, so it may not be satisfactory for the aesthetically demanding patient.
Where circumstances permit, cosmetic bridges can also be fabricated from Empress®, Emax®, Procera®, Cercon®. In spite of its good cosmetic results, Empress is a somewhat outdated or inadequate material for bridge construction. With Empress, it is not advisable to exceed 3 units or fracture may occur. Nevertheless, with Emax, strong and durable 4-unit metal-free bridges can be fabricated.
Of all full-ceramic restorations, Cercon® is the lone exception. There is virtually no limit to how many units you can do with this material, but unfortunately the lab support and the level of technician expertise for this system in Singapore are still somewhat lacking. We have tried Cercon before and found it to be less aesthetic than Empress or Emax.
Emax® should still be the system of choice for cosmetic bridges as there are a good number of labs and skilled Empress® technicians in Singapore. As there is little difference in technique between Empress and Emax, technicians already skilled in Empress should be able to do a good job with Emax. Below is an example of what the combination of a cosmetic dentist and Emax can do.
  The patient presented with 4 flaring incisors. 2 of her incisors on the right side were almost poking into her lip. She also complained that the gum level on her right canine and her incisors on the right side are not level (see line), causing her teeth to look slanted. She was initially advised to extract all 4 of her upper front teeth and have implants done. I felt the move too drastic and the aesthetic outcome too uncertain. My plan was to extract just the 2 flaring teeth with advanced gum disease. The other 2 incisors can be pushed back with a combination of elective root canal treatment and bridging with emax. Pic on the right shows the patient after extraction of 2 teeth and immediate insertion of a temporary denture.
  After root canal treatment, her teeth were cut off and rebuilt. Gum surgery was done to raise the gum level of the 2 left teeth to match that of the canine on the right. After a 2-month healing period, impressions are taken for the final bridge.
 Note the difference. This case was started in May and completed in August. cost Estimation 1. Root canal for 3 teeth S$600 2. Extraction and immediate dentures S$300 3. Gum surgery (crown lengthening) S$400 4. 5 units emax bridge S$4000 Limitations One major disadvantage for bridges as a means to replace teeth, is the necessity to trim the anchor teeth. This is certainly not an attractive option if the adjacent teeth are perfectly healthy. Some bridges are bonded to unprepared adjacent teeth with metal wings at the back (not visible), but the compromise is that these bridges are not as strong and durable.
How You Can Help Your Dentist Refer to crown section. Also remember that the dentist prepares the tooth while the technician is the one who actually fabricates the crown. A good dentist who uses a poor technician will not produce good results. For serious cosmetic work, Always encourage the dentist to send your case to the best technician he knows and don't bargain. Compared to dentures, bridges are superior in terms of strength, biocompatibility and the lack of a plastic plate that covers much of the mouth. If you wish for something better and can afford it, see your dentist who will determine whether you are a suitable candidate for bridges. Cost Estimation Porcelain Fused To Metal Bridge S$600 per unit Emax Bridge S$800 per unit Cercon Bridge S$900 per unit Check out adhesive bridges that don't require tooth preparation. Please call 62358316 for appointments or email us |
Another problem would be the lack of anchor teeth. If you have lost too many teeth, you may not have enough good teeth to support the bridge. Besides that, patients with mobile teeth and serious gum problems are also not suitable candidates for bridge construction. Nevertheless, with modern implant technology, the lack of anchor teeth is no longer a disaster as implants can be sunk into the bone to act as anchors for bridges. Of course, implants can also support individual crowns.
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