Dental Bridges Vs Implants Treatment In Malta

According to statistics, there is a high probability that you will face the following dental dilemma in your adult life – Dental Bridges or Implants?

If you are between 35 and 44, there is a 69% chance that you will have lost at least one tooth, according to a recent study (1) by the American Association of Oral & Maxillofacial Surgeons. The reasons for losing a tooth can be multiple, but the leading causes are an accident, tooth decay, gum disease or even failed root canal treatment.

You may be asking yourself, so what if one tooth has to go that as long as it’s not one of my front teeth, who will notice? Unfortunately, losing a tooth does not just cause cosmetic consequences but also further dental-related issues.

Teeth, by nature, need to remain in place to ensure the other surrounding teeth stay in the correct position. If a tooth is missing, all the adjacent teeth will begin to move, which can lead to adverse side effects such as a misaligned bite, temporomandibular joint implication, and an increased risk of gum disease and tooth decay.

Thankfully teeth replacement treatments have improved drastically over the past 25 years. The following article will examine the merits and drawbacks of dental bridges and dental implants and the options available in Malta at Savina Dental Clinics.

If you are looking for a dentist in Malta or Gozo, you can book a dental appointment online at one of Savina Dental Clinics, or contact us directly on (+356) 2125 7253 (Skyparks Business Centre, Malta International Airport), or (+356) 2155 7323 (Dingli Street, Victoria, Gozo). For international patients, it is recommended to request a free e-consultation where we can discuss your individual case and treatment options.

What is a Dental Bridge

Dental Bridge treatment falls under the category of Restorative Dentistry and is used to replace a missing tooth or teeth. The Dentist prepares the teeth on either side of the missing tooth or teeth as support to hold the false tooth/teeth in between. The term bridge is used as it bridges the gap by using the adjacent teeth to hold a structure ( in this case, a fake tooth) in place. The enamel of the adjacent teeth is filed down to allow the bridge to be fitted in parallel to the surrounding teeth to ensure the correct alignment and contact areas with the opposing teeth.

There are three main types of dental bridges available to fix different problems:

  • Traditional bridges: This involves creating a crown on either side of a missing tooth with the pontic (artificial tooth) placed in between. Traditional bridges are made out of a combination of porcelain with metal or ceramics
  • Cantilever bridges: This type of bridge is used when there are no adjacent teeth on one side of the missing tooth or teeth. This kind of procedure is not performed as often in recent years, and dentists do not recommend using this type of bridge for back teeth where too much pressure is forced upon the other teeth causing damage to the bridge.
  • Maryland bridges: These are also known as resin-bonded bridge and is either made from porcelain, porcelain fused to metal or plastic teeth and gums, which are held up by a metal or porcelain framework. This metal structure is bonded to one side of your existing teeth (not crowns) via a metal or porcelain wing.

In recent years, traditional metal-fused-to-porcelain crowns and bridges have been replaced by metal-free materials, including pressed porcelains and Zirconium cores with layered porcelain for superior aesthetics combined with strength and resistance to fracture.

History of Dental Bridges

Dental bridges are not a new phenomenon, though as they were used over 2,500 years ago by the Etruscans (powerful ancient Italy-based civilisation).

However, back then, dental bridges were a sign of status and were not used to replace missing teeth. Instead, wealthy women opted to remove their teeth by choice and replace them with gold fixtures held secure by dental bridges. It was only in the twentieth century that dentists started to use dental bridges to replace missing teeth as part of cosmetic or restorative dental treatment.

The Dental Bridge Procedure

The Dental Bridge Procedure

Dental bridge treatment requires at least two visits to your Dentist’s office. Here is a brief rundown of the process involved:

Reshaping of supporting teeth

The first visit to the dentist’s chair requires a local anaesthetic to the area around the tooth or teeth that will be used to support the bridge. The teeth are reshaped to fit the crown, which is placed on top. This process is a highly skilled activity and may take up to an hour per tooth to prepare. The crowns must be perfectly secured to keep the bridge in place.

Taking an impression

Once your surrounding teeth are reshaped, your dentist will take an impression of the missing teeth and the adjacent teeth using a rubber putty material. This mould is sent to the dental laboratory to make a custom bridge that fits your mouth precisely. As this takes a couple of weeks to make your customised bridge, your dentist will fit a temporary bridge in place which is bonded securely. You must be careful not to eat extra hard or chewy foods while wearing the temporary bridge.

Permanent bridge fitting

Your second visit to the dentist’s chair two to three weeks later will involve removing the temporary bridge and fitting the custom permanent bridge. Before fitting the permanent bridge, your dentist will clean the adjacent teeth thoroughly. While this procedure can be performed without local anaesthetic, most dentists will still recommend it so you do not feel any sensitivity or unnecessary discomfort. Your dentist will also perform some checks to ensure that your bite is the same as pre-treatment.

Aftercare advice

During the second visit, the dentist will also advise on the best way to clean the bridge properly, as this directly correlates to how long the bridge will last. One of the most common reasons a bridge fails is a cavity occurring under the supporting crowns, which is greatly reduced by good oral hygiene. A dental bridge can last more than ten years if looked after properly, which includes brushing twice daily, flossing and regular dental checkups.

Dental Bridge Treatment Case Study: Before & After

What is a Dental Implant

Before dental implants, your only option to replace a missing tooth or teeth was dentures or bridges.

A dental implant is a structure made from a synthetic yet biocompatible material (titanium or ceramic) placed in the jaw where the root of the missing tooth once resided. Implants are extremely well-designed and look and feel like natural teeth.

The implant is secured firmly to the jaw and is the foundation for which the artificial tooth or permanent bridge is placed. No preparation of adjacent teeth is required to replace a missing tooth or teeth. Implants can also be used to fix dentures if required.

Unfortunately, not everyone is a suitable candidate for dental implants. The patient must have well-established bone density and a healthy immune system for an implant to succeed. People with diabetes may present some risks for this treatment, and the same applies to people with a high propensity to clench their teeth. However, the surgeon decides which patients might not be suitable.

As with all tooth replacement treatments, strict levels of oral hygiene are required to ensure long-lasting benefits. According to American Association of Oral and Maxillofacial Surgeons (AAOMS) (2), the average success rate for dental implants is 95%.

However, this statistic is influenced greatly by the location of your missing teeth and your health and lifestyle in general. Your dentist will let you know how complicated the procedure is when performing their thorough examination, but in general, if you are considered a good candidate for dental implants, the success rate is very high.

Related Reading: Dental Implant Treatment Malta Guide

Implant Brands

At Savina Dental, we offer world-renowned implant brands at the forefront of dental implant technology.

How Long Can A Dental Implant Last?

Once a dental implant is properly maintained (which includes regular dental checkups), there is no reason to believe it will not last a lifetime. This is a huge benefit compared to a dental bridge that will need to be replaced after 10 to 15 years, even with good oral hygiene taken into account.

Dental Implants Case Study Images

Dental Implant – Three Tooth Bridge Stage 1 dental implants 3 tooth bridge stage 1

Stage 2 dental implants 3 tooth bridge stage 2

Stage 3 dental implants 3 tooth bridge stage 3

Dental Implants – Bilateral Bridges

Dental implants bilateral bridges 1

Bilateral Bridges Stage 2

Dental implants bilateral bridges 2
Partial Upper Bridge On Dental Implants – Stage 1

partial upper bridge on implants before at Savina Dental Clinics Malta

Partial Upper Bridge On Dental Implants  – Stage 2

partial upper bridge on implants 2 at Savina Dental Clinics Malta

Stage 3 – Upper Bridge On Dental Implants Completed

partial upper bridge on implants after at Savina Dental Clinics Malta

What if you are a good candidate for both bridges and implants?

If your dentist informs you that you are, in fact, a suitable candidate for both dental bridges or implants, how do you choose which is the best treatment?

Below we list the benefits and drawbacks of both to help you decide.

Benefits of Dental Bridges

  • Visually appealing, functional, predictable
  • Cost less
  • Treatment time is less to see the result

Drawbacks of Dental Bridges

  • Enamel removal required of surrounding teeth
  • If surrounding teeth already have crowns, they must be redone
  • Tooth decay of adjacent teeth is a potentially big problem
  • Additional Root canal treatment may be required if nerves of adjacent teeth are affected
  • Must be replaced after 10 to 15 years

Benefits of Dental Implants

  • Visually appealing, functional, predictable, dependable
  • It does not affect surrounding teeth
  • Will not decay
  • Fewer chances of developing gum disease
  • Can last a lifetime (with good oral hygiene)

Drawbacks of Dental Implants

  • More expensive initially than bridges
  • More planning time needed
  • Minor surgery required
  • Requires healing time before permanent tooth replacement

Dental Bridges Vs Implants: Cost Implications

Dental bridges are initially cheaper than dental implants, but due to the necessity of having your bridge replaced at a point in the future, dental implants, in fact, turn out to be more cost-effective.

Does a front tooth bridge procedure differ from a back tooth procedure?

In general, it does not. Bridges usually require at least one supporting tooth on either side of the gap. There are exceptions in less load-bearing areas where one tooth may be able to support its missing neighbour if it lies further forward to it and is smaller in size (i.e. a mesial cantilever). Distal cantilevers are not generally recommended.

Bridge or implant for a front tooth?

While both treatments are suitable for front teeth replacements, dental implants are considered better. This is because of their longevity and no effect on the adjacent teeth. On the other hand, dental bridges require adjacent teeth to be shaped too. Even so, a bridge may be your best option if the adjacent teeth have large fillings and need crowns in the future.

Tooth implant versus bridge cost?

The cost of a single implant, including the connector and crown, is approximately € 1350 to € 1,700 depending on the implant chosen, whereas that of a traditional 3-unit bridge is roughly between €1100 – €1575 depending on the material chosen. Initially, bridges may seem to be more affordable than implants. However, in the long run, implants are more cost-effective as they don’t have to be replaced as often as the bridges and do not require trimming adjacent teeth.

Temporary dental bridge versus permanent?

Temporary dental bridges are not meant to be worn over a long time because they are not durable and prone to staining and fracture. Still, in certain circumstances, some people may benefit from temporary dental bridges, for example, while waiting for the gums to heal after an extraction.

On the other hand, a permanent or fixed bridge cannot be removed by the patient. This bridge can help restore your smile, filling the space of your missing teeth. It also helps restore your speaking and chewing ability and fill out hollow cheeks where posterior teeth have been lost.

What are porcelain fixed bridges?

This is the most popular type of dental bridge. It is highly preferred for its ability to replicate the form, colour, and function of natural teeth.

What is a plastic dental bridge?

A plastic or acrylic dental bridge is a temporary bridge that is less expensive than other types of bridges.

What is a three-tooth bridge?

A three-tooth bridge is a bridge that is placed where a single tooth is missing – it consists of the missing tooth itself supported by an abutment tooth on either side.

Is there pain after a dental bridge is fitted?

This is usually a pain-free procedure. Some people may experience mild to moderate pain or inflammation. However, this often occurs when one or more teeth were already badly damaged before the teeth were prepared to take the bridge. The pain usually subsides in a few days. If it persists over a week, make sure to see your dentist as it may indicate an infection or an inflamed tooth nerve, and root canal treatment may be required.

Can dental bridges be replaced?

Yes. Depending on the cause of failure, your dentist should begin by treating the supporting teeth and ensuring they are healthy before a replacement is done.

Can a dental bridge come loose?

It can loosen if you have had your dental bridge for over several years. The movements can become problematic, leading to decay under the loose area of the bridge. It may also cause tooth sensitivity. If you notice movement, visit your dentist for a proper examination of the supporting teeth and treatment if needed. The bridge can be re-cemented if the supporting teeth are still strong enough.

Can a dental bridge be whitened?

No. Porcelain is not amenable to whitening.

Can a dental bridge be replaced with an implant?

Yes. These implants can help stimulate your jawbone and bring back the beauty lost with ageing dental bridges.

Related Reading

Book Your Dental Bridge Or Implant Consultation Appointment Today

If you are worried about a dental related issue or have questions about any of the treatments we offer, please contact us using our new free e-Consultation service. One of our highly-qualified team will respond to your query as soon as possible. Our e-Consultation service is live 9am – 6pm Monday to Friday.

If you would like to schedule an in-person consultation at Savina Dental, please book your appointment using this form.

You can also read more about all our dental treatments at Savina Dental Clinic or check out our customer testimonials section.

Savina Clinic – Dental & Implantology Centres are friendly, state-of-the-art practices in Malta and Gozo dedicated to comprehensive quality dental care. Savina Dental is an innovative dental practice in Malta. It prides itself on high-quality customer service, low waiting room times, attention to detail and the advanced dental technology at its disposal.

Joseph Xuereb
Principal Dental Surgeon & Owner of Savina Dental Clinics, Dr Joseph Xuereb BChD (Hons), MFGDP(UK), MGDS RCS(Eng), FFGDP RCS(UK), FICD is a general dental practitioner with a special interest in Implant and Restorative Dentistry. Dr Joseph & the teams' full biographical information can be found here.