A dental bridge is a fixed prosthetic device that replaces missing teeth. It consists of artificial teeth, called pontics, anchored to adjacent natural teeth or dental implants, known as abutment teeth. These abutment teeth are covered with crowns fused to the pontics, secured by dental cement. While bridges are designed to last 10 to 15 years, they are not permanent and often require professional removal. Removal is necessary when structural or biological issues compromise the bridge’s integrity or the health of the supporting tissues, allowing access for treatment or replacement.
Reasons a Dental Bridge Requires Removal
The most frequent reason a dental bridge needs removal is decay on the abutment teeth beneath the crowns. Although the bridge material cannot decay, bacteria can infiltrate the microscopic space between the crown margin and the tooth structure. This leads to cavities that compromise the tooth’s stability. Since the crown covers the affected area, this decay often goes undetected until it is advanced.
Another common indication for removal is failure of the cement bond, causing the bridge to feel loose. Over time, the luting cement degrades due to normal chewing forces and wear, allowing the prosthetic to shift. A loose bridge creates an entry point for saliva and bacteria, accelerating decay on the exposed abutment teeth.
Periodontal disease, or gum disease, severely impacts a bridge’s lifespan. If gum tissue and the underlying bone recede, the support around the abutment teeth weakens. This loss of foundation can cause the bridge to become unstable or expose the tooth roots, making the abutment teeth vulnerable to infection and failure.
Structural damage to the bridge itself, such as a fracture in the porcelain or metal framework, may necessitate removal. Although the materials are durable, excessive forces from teeth grinding or biting on hard objects can crack the bridge. Furthermore, an improperly fabricated or ill-fitting bridge can cause discomfort, bite misalignment, or make proper hygiene impossible, leading to early removal.
Techniques Dentists Use to Remove Bridges
The technique used for bridge removal depends on the prosthetic’s condition and whether the intention is to reuse it. If the bridge is structurally sound and the issue is a loose cement bond, the dentist attempts a non-destructive method. These conservative approaches involve applying controlled force to break the cement seal without damaging the restoration or the supporting teeth.
Specialized instruments, such as manual crown pullers or pneumatic devices, use rapid, controlled percussion or traction force to dislodge the bridge. These tools are designed to work parallel to the long axis of the teeth, minimizing the risk of tooth fracture or unintended extraction. Crown tractors, which grip the restoration with padded tips, may also be used to gently tug the bridge free if the cement bond is significantly weakened.
When the bridge is securely cemented, damaged, or the underlying abutment teeth require extensive treatment, a destructive removal method is employed. This involves sectioning the bridge, meaning the material is cut using a high-speed dental drill and a specialized bur. The dentist carefully cuts the bridge into smaller pieces, usually separating the pontic from the crown retainer, which allows each section to be removed individually. This method ensures complete access to the abutment teeth for necessary treatment, but it renders the old bridge unusable for recementation.
Restoration Options After Bridge Removal
Once a dental bridge is removed and the underlying abutment teeth are cleaned and stabilized, the dentist determines the next course of treatment. If the bridge was removed intact and the abutment teeth are healthy, the existing bridge may be repaired and recemented with fresh adhesive. This is the simplest and most cost-effective solution when the initial failure was due only to cement breakdown.
If the abutment teeth are still viable but required treatment for minor decay or structural repair, a new traditional bridge can be fabricated and placed. This process involves taking new impressions and designing a custom prosthetic that fits the newly treated teeth, providing a renewed long-term fixed restoration.
If the abutment teeth are severely compromised due to extensive decay, fracture, or root canal failure, they may need to be extracted. In cases where the supporting teeth are lost or deemed unreliable, dental implants are often the preferred long-term replacement option. Implants involve surgically placing titanium posts into the jawbone, which fuse with the bone to create a durable anchor for a crown or an implant-supported bridge. During the healing and planning phase for major replacement, a temporary crown or partial denture may be used to protect the prepared teeth and maintain function and appearance.