What is a gross margin bridge

Dental bridge: types, treatment & cost

What is a dental bridge?

A dental bridge (bridge for short) is a form of artificial denture that is used to replace one or more missing teeth. The neighboring teeth serve as pillars of the bridge, which can be removed and inserted permanently. The pillars are prepared like a crown and used for stabilization and fastening. There are individual dental bridges, but also those with several central parts, which are used when several teeth are missing and need to be replaced. A bridge can close tooth gaps with up to 4 missing teeth. The different types of bridges differ according to the type of attachment and the materials.

Classification of the dental bridge according to the type of attachment in the mouth

Dental bridges are usually attached to natural teeth ("abutment teeth"). These are then each supplied with an artificial tooth crown. The crown forms the anchor and is therefore also known as the anchorage crown. Before the bridge can be inserted, the teeth to be crowned must be ground down. Since the principle in dentistry is to preserve as much healthy tooth substance as possible, the quality of the abutment teeth ultimately decides which form of anchorage is chosen for the bridge.

Full crown bridge

If the teeth that are to serve as abutment teeth are already severely damaged and would have to be crowned without a bridge, a full crown bridge is required.

Partial crown bridge

If one of the abutment teeth is only partially damaged, the bridge can be attached to a partial crown. The partial crown dental bridge, however, has the disadvantage that the chewing surfaces of the abutment teeth remain partially metal-colored. The bridge is also less stable than one worn on a full crown. It is possible to equip one of the abutment teeth with a full crown and the other with a partial crown.

Adhesive bridge

In the case of an adhesive bridge (also known as an adhesive bridge, Maryland bridge), the bridge pontic is bonded to the palatal or lingual surfaces of the neighboring teeth using the acid etching technique and composite. This technique is mainly used on the front teeth and offers the possibility of keeping healthy teeth free of crowns.

Telescoping bridge

The telescopic bridge is a hybrid between fixed and removable dentures (combined dentures) and is ideal if one of the abutment teeth is unlikely to offer sufficient stability. The dental bridge is then not attached to the abutment teeth, but connected by means of telescopic crowns (double crown mechanism). Internal telescopes are firmly cemented onto the supporting abutment teeth. The removable element consists of the external telescopes, which are connected to one another via intermediate links and thus close the gaps between the teeth.

Implant bridge

If at least three teeth are missing next to each other, an implant bridge is the best solution. First, implants are placed in the jaw, which serve as artificial tooth roots and pillars for the bridge. After a healing time of approx. 6 months, the bridge is attached to them. This type of bridge is the most expensive - a three-unit implant bridge to replace three missing teeth costs at least 2,400 euros.

Hybrid bridge

A hybrid bridge (also mixed dental bridge, composite bridge, combination bridge) is used if at least two teeth next to each other are missing and at least one of the neighboring teeth is healthy or if the double tooth gap is at the end of the row of teeth. Both real teeth and implants are used as anchors in the jaw.

Cantilever bridge

A cantilever bridge (also called an extension bridge, suspension bridge) is only attached on one side and is often used when there are missing molars. If the last molars are missing, there are no more natural abutment teeth to attach the posterior end of the dental bridge to. One end of the bridge floats free. The abutment teeth are interlocked to provide additional support.

Classification of the dental bridge according to the material used

In principle, all materials that can be used for a dental crown are also suitable for the production of a dental bridge.

Gold: Dental bridges made of gold are very stable, but for aesthetic reasons they are mostly only used in the invisible part of the mouth. The bridge base usually consists of the gold-colored metal alloy on which there is a tooth-colored plastic or ceramic structure.

Metal-ceramic: These bridges are made of metal on the inside and are coated with tooth-colored ceramic. The metal-ceramic dental bridge is often used in the visible part of the mouth (incisors or canines).

All-ceramic: All-ceramic bridges consist entirely of tooth-colored ceramic, without any metal core. They have a particularly aesthetic effect and can hardly be distinguished from natural teeth.

Classification of the dental bridge according to the shape of the pontics

Bridge pontics of a dental bridge can be designed in different ways.

Tangential bridge: In a tangential bridge, the bridge pontics are heart-shaped and are often used for cantilever bridges. They only rest on the sub-points or have linear contact with the oral mucosa.

Saddle bridge:The saddle bridge has an inwardly curved shape so that the bridge pontics lie on the mucous membrane over a large area. The wide contact makes it difficult to thoroughly clean the bridge. For this reason, saddle bridges are not used in a fixed position, but only included as a removable element in prostheses (telescopic prostheses, partial prostheses).

Suspension bridges: With the suspension bridge, the pontic has no contact with the oral mucosa (approx. 3 mm distance). Cleaning is easy, while the aesthetics suffer from the gap. For this reason, suspension bridges are mainly used in the lower jaw.

Gap bridge: The gap bridge is also a form of the suspension bridge. However, it has a significantly smaller gap (approx. 1 mm) and is very difficult to clean. For this reason, it is rarely used.

Ovate Pontic: Ovate Pontic has an egg-shaped structure and “sinks” into the gums. A sufficient thickness of the mucous membrane is a prerequisite for the use of this type of bridge. The gums must also be prepared surgically and / or with the help of a temporary (sufficient indentation).

Attachment bridges: An attachment bridge is used if the teeth that are to serve as pillars differ too much (non-compensable pillar divergence). It functions as a split bridge in which the bridge pontic is only anchored to the pillar on one side and connected on the other side by means of an attachment. Attachments, which in multi-span bridges are intended to reduce tension between the individual bridge members, are called stress breaker attachments.

When do you use a dental bridge?

A dental bridge is used in the case of tooth gaps in order to improve the aesthetics as well as the speech and chewing function. Reasons for missing teeth are:

  • teeth missing from birth (hypodontia)
  • Caries
  • Periodontal disease
  • Tooth accident

The prerequisites for using a bridge are stable abutment teeth and careful oral hygiene.

There are a number of circumstances that can make it difficult to use:

  • missing bone support (attachment)
  • Defects in the jaw
  • statically unfavorable position for a dental bridge
  • Limitations of the patient that prevent adequate maintenance of the dental bridge

Dental bridge: the course of treatment

1st appointment: grinding the teeth

The teeth, which are to serve as pillars, are ground and prepared in the first session. If there is caries, it is removed and, if necessary, a filler is placed. This ensures that the pillars of the dental bridge are parallel to each other so that the bridge can be inserted. Furthermore, the tooth color for the production of the tooth-colored bridge is determined, impressions are taken and a temporary denture is used to protect the teeth.

2nd appointment: interim rehearsal

The intermediate try-in of the dental bridge is also known as a framework try-in. The accuracy of fit of the dental bridge is checked and it is ensured that the patient does not feel any tension. The laboratory will complete the dental bridge after the second appointment. If necessary, the veneering is then carried out with ceramic. In some cases, another intermediate try-in, the so-called raw fire try-in, is necessary. This is mainly done with large dental bridges in order to reduce the risk of a change in the fit.

3rd appointment: integration of the bridge

At the third appointment, the bridge is incorporated in the same way as the crown is inserted. The crowns are first inserted and glued. Accuracy of fit with respect to the abutment teeth and adjacent teeth as well as freedom from tension are ensured.

During the routine check-up, the integration of the dental bridge and its height are checked again.

Advantages and disadvantages of dental bridges

advantages

  • Long durability: A dental bridge usually lasts 10 to 20 years.
  • Lower expense: A dental bridge is less time consuming to manufacture than prostheses. The method is now part of the routine in every major dental practice.
  • Good chewing function: Unlike with dentures, the chewing pressure does not apply to the gums. The jaw structure and the chewing system are not loaded. As a result, the alveolar bone lying under the jawbone is not damaged.
  • Great treatment success: Dental bridges ensure a flawless smile both aesthetically and functionally.
  • Fixed grant: There is a fixed subsidy from the statutory health insurance classes for dental bridges.

disadvantage

  • Healthy teeth are ground: Healthy tooth substance of neighboring teeth is lost and the risk of dental disease increases as a result. The use of a dental bridge can lead to tooth decay in healthy abutment teeth. The crown margin is particularly endangered. The bridge can also overload the abutment teeth.
  • Infection risk: Grinding the teeth increases the risk of infection. The tooth enamel is attacked and the actually healthy tooth can be very sensitive to grinding.
  • Bone loss:The pontics of a bridge do not rest directly, so that the jawbone under the replaced tooth is not stressed. Thus, bone substance slowly disappears.
  • Static problems: Since cantilever bridges are only attached to your own teeth on one side and float freely on the other side, there are static problems. The abutment teeth suffer from increased stress that can permanently damage them.
  • Higher stress on abutment teeth: Potential abutment teeth are checked for stability before a dental bridge is placed. This is the only way to ensure that the bridge will hold well and that the abutment teeth will be able to withstand the additional pressure. If a tooth that would be included in the bridge construction has defects that disqualify it as an abutment tooth (severe root defects and periodontal disease), then another solution is needed. The disadvantage of a dental bridge compared to implant-supported dentures is that the abutment teeth are additionally stressed. In the worst case, this leads to the loss of these teeth.

After the dental bridge treatment: Proper cleaning and care

In addition to cleaning with a toothbrush and dental floss, bridge girders should also use interdental brushes or Superfloss (thickened dental floss) to thoroughly clean the middle section (pontic) of the bridge. The gap between the bridge abutment and the artificial tooth in particular requires special care, as food residues and therefore bacteria often settle there.

With careful oral hygiene and bridge maintenance, it can last up to 20 years or more. However, it is important to have regular dental checkups to ensure that replacements are made in good time if they wear out prematurely.

Dental bridge: cost

Depending on the material and type of treatment, the cost of a dental bridge is between 300 euros and 2,500 euros.

What does the GKV pay?

The statutory health insurances provide for a proportionate assumption of costs. A regular fixed subsidy for dentures has existed since 2005. Since October 2020, this has covered 60% of the average costs of standard care. In contrast to implants, the dental bridge is part of the standard therapy in standard care.
What is my co-payment?

What is my co-payment?

For a fully veneered three-unit dental bridge, there is still an own contribution of approx. 650 - 1200 euros. With a fully managed bonus booklet, the statutory health insurance subsidy for the third teeth increases by up to 15%.

There are a number of services that are not part of the standard health insurance coverage and that are entirely borne by the patient. The fixed subsidy from the health insurance company does not change.

You have to pay these costs yourself:

  • Costs for a tooth-colored full veneer
  • Costs for veneering the bridge in the invisible area
  • Costs for aesthetically and materially more demanding requests

These private services are billed via the fee schedule for dentists (GOZ) and can vary greatly depending on the price and laboratory costs.

What does German Family Insurance pay for?

With the DFV-ZahnSchutz you are well protected against high costs at the dentist. The supplementary dental insurance of the German family insurance was for the 5th time in a row Stiftung Warentest test winner with the absolute top grade of 0.5. You will receive up to 100% reimbursement for all dental and orthodontic services. Of course, high-quality bridges that go beyond the standard coverage of the health insurance are also included.

Medical treatments completed before the application is submitted are also included in the insurance cover. For example, the repair of an existing tooth crown or tooth filling is covered.

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The six-time Stiftung Warentest test winner DFV-ZahnSchutz will reimburse up to 100% of the cost of your dental bridge!

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Dental bridge FAQs

When can bridges fill a gap?

Bridges can close tooth gaps that comprise one or more teeth. The prerequisite is that the abutment teeth are stable.

How many appointments do I need for a dental bridge?

To use a dental bridge, you need 2 to 4 appointments, depending on the scope and type.

How long does the treatment with a dental bridge take?

As a rule, three appointments with the dentist are necessary to insert a dental bridge.

What is a dental bridge attached to?

A removable bridge is attached to natural teeth or dental implants with double crowns (also called telescopic crowns). A fixed bridge is screwed onto dental implants.

When does a dental bridge need to be removed?

A dental bridge must be removed if an inflammation has developed under the bridge or if the dentition has changed to such an extent that the bridge no longer fits correctly. Removal of older bridges can also result from discoloration.

How long is a dental bridge guaranteed?

The legislator basically provides a two-year guarantee for the supply of dentures. If problems arise with the bridge during this time, the treating dentist is obliged to repair them free of charge.

What does a bridge cost for one tooth?

The costs for different types of bridges vary. For example, a simple dental bridge on two of your own teeth costs between € 850 and € 2,100.

Which dental bridge does the health insurance company cover?

In accordance with the standard care, the health insurance company pays half of the costs for a metal bridge with front facing. The patient pays an own contribution of approx. 400 - 500 euros.

What is a cantilever bridge?

A cantilever bridge (also known as an extension bridge or trailer bridge) is a dental bridge that has at least one pontic that replaces the missing tooth and is only supported on one side by an abutment tooth. The other side floats freely.

All statements without guarantee.