A simple guide to implant-supported bridges

Dental bridges have long been an effective strategy for replacing missing teeth. By attaching one or more artificial teeth (“pontics”) to adjacent crowns (“abutments”) cemented on healthy teeth, dentists can fill in the gaps in your smile.

But what if a patient doesn’t have enough healthy teeth to support crown abutments? In these cases, a dental implant supported bridge may be recommended.

Why implant-supported?

An implant supported bridge functions in roughly the same fashion as a traditional bridge, except that it is fixed in place with implants instead of crown abutments cemented to healthy teeth.

There are four primary reasons why an implant-supported bridge may be the preferred solution:

  1. The patient is missing multiple teeth or adjacent teeth are not sufficiently healthy enough to support a bridge.
  2. The dentist or oral surgeon is concerned that using separate crowns on individual implants will put too much pressure on them and potentially lead to failure. For patients with less than ideal jawbone strength, spreading the pressure across multiple posts with a bridge greatly decreases the chances that screws will loosen.
  3. The missing tooth is positioned in the upper arch in an area that is too close to the sinus cavity or a nerve to place an implant.
  4. There is insufficient or unhealthy jawbone directly above or below the missing tooth.

How does it work?

An implant-supported bridge is made up of three parts:

  1. Implant: Titanium rods are surgically placed in the jaw to fuse with the bone. These serve as anchors to support the bridge.
  2. Abutment: A gold, titanium or porcelain cylinder is screwed to the implant.
  3. Restoration: A series of porcelain crowns is attached and fused to the abutment substructure.

How long does it take?

The time it takes to complete the entire process will vary. From jawbone health to the position in the mouth to the number of implants and other factors, only your oral surgeon can accurately predict the full timeline given a certain set of circumstances.

Typically the procedure requires a preop consultation, two surgeries and then additional fittings and checkups. During the initial operation the oral surgeon will drill titanium implants into the jawbone and cover them with gum tissue until full fusion is complete.

In the second surgery, a small incision in the gum tissue exposes the implants so that abutments and eventually the bridge can be installed.

General time guidelines are as follows:

  • 3-4 months for implants to fuse in the lower jaw, 3-6 months for the upper jaw. An X-ray may be taken to determine successful fusion before scheduling the second surgery.
  • Patients requiring bone grafting may wait an additional 4-6 months prior to the initial surgery depending on the severity of atrophy.
  • During the second surgery, a healing cap will be attached to the implants to allow for the gums to heal properly for 3-4 weeks.
  • Patients should return in 6 months for a checkup.

Expectations and care

Once complete, an implant supported bridge will both look and function like your natural teeth. Pontics are brushed the same way as your other teeth apart from possibly needing to use a special floss or brush to clean between the bridge and gums.