Different Dental Bridge Materials

Natural Tooth

This option is mainly for resin bonded bridges. Sometimes the natural tooth can be used once removed and placed back attached to adjacent teeth. This is for unique circumstances like a horizontal root fracture of a lower front tooth. It can bee added to the adjacent teeth. There is risk of caries or gum disease affecting the adjacent teeth if not cleaned properly. Overtime there is the risk of staining, discolouration, debonding and breaking. The advantage is it can be placed quickly, looks like a tooth and does not require the lab.

Composite

This option is mainly for resin bonded bridges, this is when the tooth is made out of filling material. This takes time in the chair can have staining, discolouration, debonding and breaking. The advantage is that is usually is cheaper than the other options.

All Ceramic

The main advantage of all ceramics is the aesthetics, all ceramics tend to look the most like teeth. They take up less space then PFMs, as a result they are often used for aesthetic cases. The disadvantage has been deterioration of mechanical properties. In the past, all ceramics were not as strong as alternative options, but each new version they are improving the strength. In the future with further research and improvements this may be the new gold standard.

Porcelain Fused Metal (PFM)

This is a mixture of both ceramic and metal. As result it combines both the aesthetics of porcelain with the strength capabilities of metal. Taking the advantages of both of these materials. The disadvantage of this, is there is often the risk of chipping porcelain and having a metal strip around the gums, which can affect the aesthetics. Due to having two materials joined this crowns often need more space as well.

Gold (Precious)

Ironically, Gold is often referred to as the gold standard for dental crowns. The reason why gold is highly favourable for dental crowns is due to its longevity, functionality and biocompatibility. This material is very versatile, its properties allow it to have a lower hardness than the outer layer of the tooth (Enamel) which reduces wear on opposing teeth but stronger enough mechanically to withstand the forces a tooth needs to undergo. The main disadvantage with gold is the cost, colour and aesthetics.

Metal (Non Previous)

Metal similar to gold, it has good mechanical properties and is ideal for people with very strong bites. It is often used when gold is not available due to cost.The main disadvantage with metal is the colour and aesthetics.

Why is the state of the adjacent teeth important?

In order to place a crown you need to file/shave the tooth down. This can be beneficial in adjacent teeth that have multiple fillings as this can strengthen and protect them. However, if it is a tooth that does not having fillings then your committing the tooth to the restoration cycle. Unfortunately nothing is permanent in life and eventually that bridge will wear down. If you take good care of it you may be able to replace it with another bridge if not then those teeth may also need to be removed which can limit your options later. As a result it is often advised that if you have healthy unrestored adjacent teeth that you place an implant as that does not shave the adjacent teeth. Another important aspect is assess the supporting structure of adjacent teeth (this being the gums and bone). If the gums are unhealthy resulting in wobbly teeth it is strongly advised not to place a bridge as this will make the mobility worse and the bridge will not last long. That is why it is important to get your gums checked also, as you need good support.