Dentistry focuses on diagnosing, preventing, and treating conditions of the teeth, gums, and oral structures, supporting oral health and overall well-being.

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Dental Bridge: Treatment and Care

The clinical execution of a dental bridge at Liv Hospital is a meticulous procedure that blends microsurgical precision with artistic reconstruction. The treatment workflow is designed to minimize biological trauma to the abutment teeth while ensuring the mechanical durability and esthetic integration of the prosthesis. The process involves distinct phases: preparation, temporization, laboratory fabrication, and final cementation. Post-treatment care is equally vital, as the long-term success of dental bridges depends on maintaining periodontal health and the integrity of the luting agent. We utilize advanced ceramics and digital workflows to streamline this process, offering patients durable solutions like zirconia dental bridges and complex dental implant and bridge rehabilitations.

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Phase 1: Tooth Preparation and Temporization

DENTISTRY

The initial clinical appointment focuses on preparing the foundation for the bridge.

  • Anesthetic Management: Profound local anesthesia is administered to ensure patient comfort. In cases of dental anxiety, sedation options are available.
  • Abutment Preparation: The dentist carefully reduces the enamel and dentin of the abutment teeth to create space for the restorative material. The preparation geometry is critical; it must possess adequate retention and resistance form to prevent the bridge from dislodging. The margins of the preparation are placed either equiginivally or slightly subgingivally to ensure esthetics and periodontal health.
  • Digital Impressioning: Unlike traditional methods, Liv Hospital employs intraoral scanners to capture a micron-accurate digital impression of the prepared teeth. This eliminates distortion and provides the dental laboratory with a perfect virtual model.
  • Provisionalization: A temporary acrylic bridge is fabricated and cemented immediately. This provisional restoration protects the exposed dentin, maintains tooth position (preventing drift), stabilizes the occlusal relationship, and serves as a blueprint for the final esthetics.
Icon 1 LIV Hospital

Phase 2: Laboratory Fabrication and Materials

DENTISTRY

The digital file is transmitted to the dental laboratory, where the bridge is engineered.

  • CAD/CAM Milling: The bridge framework is designed using Computer-Aided Design (CAD) software. For zirconia dental bridges, the structure is milled from a monolithic block of pre-sintered zirconia using Computer-Aided Manufacturing (CAM). This process ensures structural homogeneity and eliminates the risk of casting voids associated with traditional metal bridges.
  • Ceramic Layering: To achieve lifelike esthetics, particularly for dental bridge front teeth, skilled ceramists may layer feldspathic porcelain over the zirconia core. This imparts natural translucency, opalescence, and fluorescence to the restoration.
  • Pontic Design: The undersurface of the pontic is contoured to form a convex or ovate shape. This “self-cleansing” design minimizes food impaction, promotes proper hygiene, and maintains contact with the soft tissue for a natural emergence profile.

Phase 3: Delivery and Cementation

The final appointment involves the permanent fixation of the prosthesis.

  • Try-In: The provisional bridge is removed, and the final bridge is seated. The fit is verified radiographically and clinically to ensure marginal integrity. The occlusion is checked with articulating paper to ensure simultaneous contact with the rest of the dentition.
  • Esthetic Verification: The patient evaluates the appearance, color, and shape of the bridge to ensure it meets their expectations for the before and after bridge dental expectations.
  • Bonding/Cementation: Depending on the material, the bridge is either cemented with glass ionomer or bonded with resin cement. Resin bonding is critical for Maryland bridge dental and all-ceramic restorations to achieve maximum retention and strength. Excess cement is meticulously removed to prevent peri-implant or gingival inflammation.

Advanced Clinical Scenarios

  • Implant-Supported Bridges: In cases of dental implants and bridges, the protocol involves a surgical phase for implant placement, a healing phase for osseointegration (3-6 months), and a restorative phase. The bridge is then screwed or cemented onto the implant abutments.
  • Cantilever Designs: For a cantilever bridge, preparation is limited to a single abutment. Careful occlusal adjustment is performed to ensure that no heavy forces are placed on the pontic during excursion movements.

Post Treatment Care and Monitoring

  • The longevity of the bridge depends on the biological health of the abutments.

    • Occlusal Guard: For patients with bruxism, a hard acrylic night guard is fabricated to protect the ceramic from fracture and the abutments from traumatic occlusal forces.
    • Follow-Up: Regular recall appointments are scheduled to monitor marginal integrity, periodontal health, and occlusal health. Radiographs are taken periodically to check for secondary caries under the crowns.

Managing Biological Complications

Pulpitis: If an abutment tooth develops sensitivity or pulpitis (nerve inflammation) after preparation, endodontic (root canal) therapy may be required. In most cases, this can be performed through an access opening in the bridge without removing the restoration.

Regenerative Maintenance

  • Soft Tissue Management: If gum recession occurs over time, mucogingival grafting procedures can be performed to cover exposed roots and improve the esthetics around the bridge margins.

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FREQUENTLY ASKED QUESTIONS

Is the preparation of teeth reversible?

No, the removal of enamel for a traditional dental bridge is irreversible; the tooth will always require a crown or coverage thereafter.

Zirconia is extremely durable and resistant to fracture; with proper care, these bridges can last 15-20 years or more.

No, ceramic materials do not respond to whitening gels; if you wish to whiten your teeth, it should be done before the bridge is fabricated to match the lighter shade.

Initially, there may be minor changes in speech, but patients typically adapt within a few days; a bridge on front teeth often improves speech by closing gaps.

If one of the supporting teeth fails due to decay or fracture, the entire bridge usually needs to be removed, and a new treatment plan, potentially involving implants, must be devised.

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