Fixed adhesive bridges

The adhesive bridge is a non-removable structure that literally adheres to adjacent teeth with the help of special devices that do not cause interference and do not need to be removed during further operation. The most important advantage is the absence of the need to grind the teeth adjacent to the defect under the crowns.

At present, adhesive bridges are positioned as a serious alternative to classic bridges - from stamped-soldered to metal-ceramic constructions. When installing a classic bridge, the abutment teeth (sometimes absolutely healthy) are grinded, after which the crown of the bridge (on cement) is installed on them.

When it comes to prosthetics of several teeth, the application of the classical design is quite reasonable and justified, but is there any point in replacing a defect with a standard bridge in the absence of only one tooth? Indeed, for the sake of a single defect, it would have been necessary to “mutilate” (to grind, and sometimes even to add, also to pulp) two innocent neighboring teeth.

It is worth noting that the loss of one tooth by many people at first is not taken seriously (except, perhaps, in those clinical cases when the defect appears in the smile zone). However, with the loss of any tooth, the integrity of the entire dentition is violated, against which the normal function of chewing food is disrupted and dento-maxillary pathologies (malocclusion and other no less unpleasant consequences) are gradually formed.

On a note

This is especially true for chewing teeth, which almost always determine the performance of a normal bite and the ratio of dentition. With the loss of at least one chewing tooth, its neighbors quickly begin to behave “inadequately” - they shift (tilt) in the direction of the defect. As a result, the entire dentition can "swim".

In order not to be embarrassed by a broad smile and not feel uncomfortable when chewing, it is important to contact the dentist as soon as possible to eliminate the defect by prosthetics. To eliminate a single defect, the following options can be considered:

• Using a butterfly prosthesis. But it is removable, which creates inconvenience in operation;
• Implant prosthetics. This is the best option in terms of aesthetics and functionality, but usually a long one (several months) and not everyone can afford it (it will cost about 70-100 thousand rubles);
• The classic bridge. As already noted above, it is difficult to call this option optimal, since you will have to grind two supporting teeth under the crowns;
• An adhesive bridge, as an alternative to a standard bridge, with minimal impact on adjacent abutment teeth.

 

Advantages of Adhesive Prosthetics

The choice in favor of an adhesive bridge is determined, in addition to the indications, by four main advantages, which can be very tempting, especially against the background of comparison with other options for prosthetics.

These are the benefits:

1. Odontopreparation (turning) of teeth adjacent to the defect is not performed. In other words, to fix the structure, it is not necessary to remove the enamel from the surfaces of healthy teeth, unlike prosthetics with stamped-brazed crowns and, all the more, metal-ceramic. In the latter case, the tooth is sharpened so seriously that it is often necessary to pre-pulp it, that is, remove the “nerve” so that it doesn’t get sick under the crown (this most often stops people from choosing the classic bridge);
2. In most cases, even anesthesia is not required. To some extent, many people are afraid not only of toothache that occurs when using a drill, but even of the “painkiller injection” itself. And since adhesive prosthetics is carried out without turning the teeth, the risk of pain with a slight surface effect on the supporting teeth is minimized. The use of anesthesia is possible in special clinical cases and in consultation with the patient;
3. The speed of manufacture of the prosthesis - usually enough from 1 to 3 days. When it comes to prosthetics in one visit, the entire fixed structure is made in the patient’s oral cavity from beginning to end. You have to wait a little longer in cases where the laboratory stage of manufacturing the prosthesis is added;
4. The relatively low cost of the service. In comparison with other constructions of similar functional and aesthetic characteristics (cermets, non-metal ceramics, etc.), an adhesive prosthesis in most clinics will cost less.

The photos below show an example of premolar prosthetics using an adhesive bridge:

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Adhesion (from lat. Adhaesio - adhesion) means adhesion (gluing) of materials of different nature to each other. The adhesive prosthesis is glued to adjacent teeth using special dental materials. Such a prosthesis is sometimes also called the Maryland Dental Bridge, Rochetta Retainer, or Manhattan Bridge.

 

In what cases does it make sense to put an adhesive bridge?

Installation of an adhesive bridge is a simple and quick way to eliminate a dentition defect, and in terms of speed of implementation, this method today continues to be a leader among other varieties of prosthetics. However, despite the serious advantages, adhesive prosthetics is not always used - it has its own indications and contraindications.

There are few general contraindications to the installation of an adhesive prosthesis. First of all, it is not recommended to make this design in people suffering from epilepsy, since it easily breaks during a seizure.

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It should be borne in mind that the prosthesis can also break if there is a habit of biting nails, pens, pencils.

There are local factors that impede the use of an adhesive prosthesis:

1. Significant extent of the defect. In other words, adhesive prosthetics for more than 1-2 teeth have the risk of rapid breaking or cracking of the bridge. This is especially true for the chewing area, where the main burden occurs during chewing. Today, doctors recommend replacing only 1 missing tooth, and best of all - in the anterior section, where the load on the teeth is relatively small. With a large extent of the defect, it may be more appropriate to use a classic bridge or a removable clasp prosthesis (see photo);
2. The supporting teeth have significant defects and (or) are in the wrong position. Adhesive prosthetics in these cases is possible only with appropriate tooth preparation and serious orthodontic treatment, so sometimes it is more rational to choose another type of fixed prosthetics, in which you will not have to wait years for a quality treatment, correcting dental anomalies;
3. Abutment teeth have mobility or pathological abrasion.

On a note

Poor oral hygiene in general can also create many problems with the use of the prosthesis. Poor hygiene in most cases is a serious obstacle to any type of treatment in dentistry, and for adhesive prosthetics, in particular, since the specificity of fixing the structure while ignoring hygiene products will further contribute to the development of caries in the area of ​​abutment teeth.

In other cases, adhesive prosthetics may be a reasonable solution.

 

Composite adhesive bridges made right in the dentist’s chair

Composite adhesive bridge prosthesis in Russia was first learned thanks to the development of Sergey Radlinsky, which began in the early 90's. It was his works that laid the foundation for the creation of a qualitatively new direction of restoration of a lost tooth - with the help of ordinary light-cured fillings and special technical devices.

The essence of the idea is very simple: you need to securely adhere an artificial tooth to adjacent abutment teeth. An auxiliary reinforcing device may be a metal wire - it, relying on teeth adjacent to the defect, is the basic basis of an adhesive prosthesis. The manufacturing process of such a bridge is as follows: small cavities are created on the enamel of adjacent teeth, where the wire then enters.

Will there be pain at the stage of “drilling” these artificial furrows with a drill?

In practice, most often anesthesia is not required at all, since dental treatment is minimal. In addition, often supporting teeth on the contact surfaces (closer to the removed tooth) have fillings, removing which, you can get a good bed for fixing the beam. In an extreme case, dentists today have a whole arsenal of anesthetics for reliable pain relief.

A more advanced technology is adhesive prosthetics using fiberglass in the form of tapes and bundles. In this case, instead of the wire, they are inserted into the formed grooves on the abutment teeth, and then an artificial tooth from the composite is recreated on them.

Usually patients are interested in how much time it takes for the doctor to “build up” a new tooth in the mouth in one session?

It is worth noting that the creation of an adhesive bridge from a light-cured composite is almost jewelry work, requiring the doctor not only knowledge and experience with such restorations, but also a certain amount of exposure, since you can’t rush in this business. "Light" materials are applied to a metal beam or fiberglass in small layers with the phased use of special matrices and "shapers" of the future tooth. Work can take from 1.5 to 4 hours: it is precisely the exact fulfillment of all requirements that makes it possible to make a high-quality and reliable bridge prosthesis.

It is interesting

An artificial tooth made of composite does not lie on the gum - like the classic analogues of metal and ceramics, the prosthesis has a washing space between the gum and the artificial tooth. The photo below shows how it can look in life:

Adhesive prosthetics has many similarities to the artistic restoration of a tooth, only in the latter case, one's own tooth is used as a support, and adjacent teeth with beams thrown between them are used to create an adhesive bridge. Ideally, at the end of work, the tooth cannot be distinguished from its own, as the master recreates all the tubercles, fossae, grooves, and also imitates the color and even the natural luster of the surface.

Review of one of the practicing doctors:

“I am generally skeptical of the instantaneous methods of restoration such as direct veneers or composite bridges. But even if you do, then it is better to choose the manufacture in the laboratory, as they are much stronger than the cabinet "creativity", plus better made ... ".

Alexander V., Moscow

 

Laboratory (indirect) method for manufacturing an adhesive bridge

Unlike adhesive prosthetics using the direct method, the laboratory method of obtaining the bridge is more accurate and reliable, because about half of the work is done not in the patient’s mouth (these are, frankly, not the most favorable conditions), but in the dental laboratory.

The indirect method of such prosthetics includes 4 main stages:

1. Treatment of supporting teeth (different, depending on the clinical situation). This is not a “turning” of a tooth from all surfaces, but grinding, groove cutting, or even caries treatment - cleaning the cavity from carious tissues and adapting it to fix the beam of the future prosthesis. Grinding is important for reliable adhesion of the prosthesis to the tooth surface;
2. Imprinting (casts). With the help of special pasty materials introduced into the oral cavity on spoons, a negative image of the surface (relief) of the oral cavity with all teeth is obtained;
3. Making a prosthesis. For this, ceramics and plastic can be used. A plastic adhesive bridge is cheaper, but will be much less durable than a ceramic one;
4. Fixing prostheses on abutments using dental cements.

Feedback:

“Recently I lost a lateral tooth (the first after the canine). The crown stood for a long time, but the root cracked, although I thought that it would stand up to old age. I can’t remember without tears, I suffered a lot when the remnants of the root were removed. It was a pity, but I was afraid to prosthetics, since I would have to spoil the adjacent teeth. I didn’t even wave to implants, very expensive. I came for the sake of curiosity to the clinic near the house, and left with a brand new tooth, which was made directly from the filling for only 7 thousand rubles! True, they told me that biting hard is now not recommended ... "

Oksana, Novosibirsk

 

What is useful to know about the disadvantages of adhesive bridges

Despite a number of enthusiastic reviews about the use of adhesive bridges, in addition to significant advantages, they also have serious disadvantages, which are useful to know in advance.

First of all, the fact that adhesive prosthetics belongs to the category of temporary replacement of an absent tooth should be noted (despite the fact that in some clinical cases this period can be 5-7 years). But, as they say, there is nothing more permanent than temporary, and in Russia (not from a good life) today many temporary dental prosthetics are used by patients for many years as permanent (butterfly prostheses, full removable acrylic prostheses, adhesive bridges, etc.). )

That is why it is not worth surprising that the main disadvantages of the prosthesis are the fragility and fragility of the structure (in many ways, it is recommended that no more than 1 tooth be prosthetized and, if possible, only in the anterior section).

On a note

Adhesive bridges successfully replace 2 removed teeth, and even in the lateral section, when there are no molars. However, one can often encounter situations where all the work goes down the drain in the first year after prosthetics - because of an apple, a crust of bread, a barbecue, etc. That is, even if the dentist makes the prosthesis as close to the original bite as possible, returning the replaced tooth to its function, careless behavior regarding food intake can easily cause breakage at the first opportunity.

From the foregoing, another disadvantage of adhesive prosthetics follows - the ability to restore mainly only cosmetic defects, without returning a new artificial tooth to full-fledged active work. That is, the tooth will not be fully involved in the load - in the bite, along with other teeth, it simply will not be.

Review by a practicing dentist (taken from the dental forum):

“Most of my patients have a negative attitude towards the placement of crowns on their teeth, especially when it comes to intact teeth. So the soviet mentality is manifested, which is very difficult to overcome.I always plan an adhesive prosthesis as a splinting structure and immediately stipulate that it is temporary (albeit for a LONG time). And in the future it will be necessary to put a full-fledged bridge. Maryland is well used at a young age as a sparing option for prosthetics ... "

George, St. Petersburg

What to do if the adhesive prosthesis still breaks?

Depending on the specifics of the problem, there is a help tactic. In some cases, repairing an adhesive bridge is possible, but a highly professional doctor will always take into account the causes of the failure.

For example, if the problem with the adhesive structure does not appear for the first time, then this may indicate the effect of excessive load on it due to the nuances of the bite. It may well turn out that there is no reason to redo it every time, wasting time and money, but it is advisable to make classic metal ceramics or ceramics based on processed neighboring teeth and forget about the defect for 10-15 years.

 

What makes the final cost of prosthetics

The price of adhesive prosthetics consists of many components. The status of the clinic, the level of organization and equipment of rooms, as well as the fame and qualifications of staff can have a significant impact on pricing.

Composite adhesive bridges are much cheaper than their laboratory-made counterparts: cermet and ceramic. At the same time, ceramic-metal adhesive structures, in turn, cost less than ceramic ones (lower cost of materials, lower complexity of manufacturing technology, but somewhat lower aesthetics).

As a result, prices for adhesive dentures today vary from 5 to 30 thousand rubles or more (the cost is "turnkey").

On a note

It may seem surprising that adhesive prostheses are sometimes more expensive than reliable classic bridges, which can stand without problems for more than 10 years. But here it must be borne in mind that sometimes people are willing to pay not so much for the opportunity to chew with artificial teeth for many years, but for the chance to leave healthy teeth adjacent to the defect not turned and alive, albeit with the help of a functionally less perfect prosthesis.

 

If you have personal experience using an adhesive bridge, be sure to share the information by leaving your review at the bottom of this page.

 

Interesting video: a clear example of the manufacture of an adhesive bridge from start to finish

 

What is useful to know about bridges