Dental implant vs. bridge: which one replaces a missing tooth?

How does a dental implant work?

A dental implant replaces the root of the tooth. It has three parts. The first part is a post that goes into the bone, called the fixture, and it steadies both the bone and the crown. The second part is a connector called the abutment. The third part is the crown, which is the piece that looks like a tooth.

The bone needs time to grow around the fixture. That healing step is called osseointegration, which just means the bone locks onto the post. We compare it to setting a metal post in wet concrete. You would not want to move the post while the concrete sets. So the fixture is often left alone for a few months before the abutment and the crown go on. A select few patients get a crown the same day. More often a small temporary is placed over the area so the spot still looks good while it heals.

Sometimes the post can go in the same day the tooth is taken out. An infection, or a defect in the bone where an abscessed tooth was removed, may mean waiting a few weeks so the area can clear. If bone grafting is needed to build up the area, or if the sinus has to be lifted to make more height, the next step may be six to nine months later.

How does a dental bridge work?

A bridge uses the teeth on each side of the gap as anchors. Those teeth are prepared for crowns, and the crowns connect and fill in the space left by the missing tooth. The finished bridge is fixed in place, so you do not take it out.

At Pearl Dental Care, crowns and bridges can be made in porcelain, gold, or porcelain fused to gold. Many patients like the newer all zirconium crowns and bridges, which can have the strength of metal with the look of porcelain. We take a digital scan of the prepared tooth instead of a putty impression, and that scan is on its way to the lab within minutes. The work is done in two visits, with an acrylic temporary tooth in place for one to two weeks to protect the tooth and hold the space.

What is the biggest difference between them?

It comes down to what holds the new tooth up.

• An implant sits in the jawbone and stands on its own, so the healthy teeth beside the gap are left alone
• A bridge leans on the two teeth next to the gap, and those teeth are prepared for crowns
• An implant replaces the tooth root, which helps support the bone in that spot
• A bridge does not involve surgery, and the work is usually finished sooner

Single tooth implants are becoming the standard of care, because many people would rather not drill down two healthy teeth to hold a bridge. That matters most in the front of the mouth.

Am I a candidate for a dental implant?

Most people are. Years of severe bone loss can make it harder. So can health conditions that make it tough for a titanium post to join with the jawbone. We look at a few red flags first, including smoking, diabetes, blood thinners and chemotherapy. A red flag does not always mean no. It may mean timing the work differently or taking extra care while it is done.

How does Pearl Dental Care plan the work?

We have a 3D Vatech cone beam machine, a low dose CT scanner. It shows the height, width and density of the bone before an implant goes in, so we can tell whether the base is strong enough to hold it. It also shows blood vessels and nerves inside the jaw so they can be avoided. Before anything starts, your dentist sits down with you and goes over your x-rays, your bone health, your medical history and your choices.

To ask a question or book a visit, call Pearl Dental Care at (630) 810-9940 or visit us at 331 W 63rd St, Westmont, IL 60559.

This guide is educational only. Your dentist will tailor any plan at your visit.