Dental implants are nowadays imposed as one of the best dental solutions after tooth loss, but in everyday practice dental titanium screws are not always the best option for all situations. Dental implants are a more expensive option than dental ceramic bridges, while the period of making dental implants is longer than it is for porcelain bridges. Dental porcelain bridges include interconnected dental crowns that rely on existing teeth in the jaw from both sides. To make the bridge, it is necessary to buff the adjacent teeth so that they serve as carriers. Therefore, making a ceramic dental bridge requires that there are natural teeth in the jaw on both sides, and it is also necessary that the future bridge carriers are stable in the jaw bone, without the presence of periodontal disease, so as to withstand the weight of the bridge. In that way, it can be said that dental bridges are a contraindication in already present periodontal disease, when there is an observed oscillation of the teeth and large range between teeth, like a bridge between the 3s and 8s.
Even when the patient insists on placing dental implants, there are situations when porcelain bridges are a better solution. These are the cases when there is not enough jaw bone for implant placement, when the important nerves and sinuses are near, or when the general health situation is bad or the patient has a lot of bad habits.
Dental bridges alone are made of metal or zirconia construction and planned to withstand the weight of everyday activities. In order for a dental bridge to have years in perspective it is necessary to make a detailed plan administered therapeutically, where it is necessary to consider the state of the teeth carriers and the distance between them. Teeth that have little space in bone and are at greater distance (eg, 3 and 7) have a worse prognosis than a bridge between 4 and 6. Dental bridge planning is done by gently pressing gums in the places where teeth are missing and thus simulating the mouthfeel that there are actual teeth. Also, thanks to the slight contact with the gums it never comes to the withdrawal of gums under the bridge, except in cases where the dental bridge is made immediately after tooth extraction, which has to be avoided.
Tooth itself is attached to the jawbone with fibers and is characterized by micromovements, while dental implant after implantation into the jawbone and after its bone integration does not have any fibers. Any movement of the artificial dental screw is undesirable and can lead to loose teeth and bone loss around dental screws. Thanks to the natural micromovement of teeth, dental ceramic-span bridges needn’t be an ideal match with the teeth trace because there will always be a slight tooth movement over time. However, there are cases when placed dental implant is later bonded with a healthy tooth through a dental bridge, either for financial reasons or because there are no conditions for the placement of the required number of dental implants. In such cases, we suggest root canaling of healthy teeth, ie. to create a channel in order to firm the tooth in the jawbone, which has certain advantages and disadvantages that are presented to the patient.