What Is an Implant-Supported Bridge?

Implants are placed in the gap, and a bridge of joined crowns is attached to them. The implants do the job of roots, so the neighbouring natural teeth are left alone. A typical example is three or four missing teeth in a row restored on two implants, with the bridge carrying a crown on each implant and a crown spanning the space between.

The bridge can be screw-retained, which allows it to be removed for repair, or cemented. The connecting parts are the same as for a single implant. The surgery follows the same steps as for a single implant, see dental implant surgery.

Replacing each missing tooth with its own implant gives the most independent result. Each crown can be cleaned and, if needed, repaired on its own, and the load is spread. It needs more bone and more surgery, and costs more.

A bridge on fewer implants needs less bone, fewer surgeries and usually a lower cost. The trade-off is that every part is linked: if one implant fails or a screw loosens, the whole bridge is affected. There is also a limit to how far a bridge can span. Long gaps, a heavy bite or tooth grinding may call for an extra implant. The number is decided from your scan and bite, not from a rule of thumb.

A conventional bridge needs the teeth on either side of the gap to be cut down and crowned to hold it. That is acceptable when those teeth already need crowns, and it is quicker and cheaper. The implant versus bridge guide sets out the full comparison for one tooth.

An implant-supported bridge does not load the neighbours and gives the jawbone a root to work against, which helps limit bone shrinkage under the gap. The cost is a longer timeline, since the bone needs months to bond to the implants, and surgery. The gum under a conventional bridge may also slowly recede and leave a visible gap, which is less likely when implants hold the bone. It also depends on having enough bone, so a graft may be needed first. See dental implant bone grafting.

Food and plaque collect beneath the joined section, and this is where gum inflammation around implants begins. A toothbrush does not reach it. Floss threaders or superfloss slide under the bridge, interdental brushes clean the sides of each implant, and a water flosser flushes the area, which many people find easiest.

Pay particular attention to the gum around each implant, since bleeding there is an early warning. Do this daily, and expect maintenance visits every few months with scaling and X-rays. The routine is covered in how to look after dental implants. A bridge designed with a small, cleansable gap beneath is easier to keep healthy than one that presses tight against the gum.

It also needs a bite that the implants can carry. A person who clenches or grinds heavily puts more force on a long bridge, and a night guard or an extra implant may be advised. It tends to suit two to four adjacent missing teeth, especially at the back of the mouth, where bone can hold implants but the gap is too long for a sound conventional bridge. It also suits someone who does not want healthy neighbours trimmed.

It is less suitable when the bone is thin and a graft is not wanted, when gum disease is active, when someone smokes heavily, or when a single missing tooth is better served by a single implant. A single gap is usually simpler. Full-arch cases are a different category, covered under full mouth rehabilitation. Call the clinic to ask about options for your gap, and for the written plan and cost, see the dental implants page.

After examination and a scan, the implants are placed under local anaesthetic, and the bone is left to bond for a few months, as described above. A temporary tooth or removable plate is normally provided so that you are not left with a gap. Impressions or a digital scan follow, then the bridge is made and fitted.

In total, expect several appointments over about three to six months, longer if a graft is involved. The dentist checks the bite at fitting, since a bridge that hits too hard carries extra load onto its implants. A night guard is often advised if you grind your teeth, because it protects the porcelain and the screws.