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Broken Bridge Teeth - Repair Options
Fixed bridges, whether cement or screw retained, have degrees of endurance and servicability that can be as much as 30 years or more..... or as short as a few weeks or months.. and everything in-between.
Why Bridges Fail
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| Broken Maxillary Bridge Crown |
The causes of failure are numerous and differ for each patient. Technical errors, fabrication failure, unusual occlusal events, food preferences, trauma, unbalanced occlusion, incisal edge characteristics of opposing teeth, failure to maintain oral health issues involving bridge attachment, failure to maintain oral health for remaining dentition... and so on.
A bridge that provides good service, endurance and continues to "not" look like a bridge for, say 25-30 years, understandably results from good dentistry and optimal oral health care exercised by the patient.
Bridgework that endures only for a short time, say 15 years or less, brings into question all of the casual factors mentioned above.
What - How - Why Failure Characteristics
The dynamics of a bridge becoming unservicable will vary, change and become more complex with the age of the bridge and changing oral health conditons of any given patient. Even "chains of change" will cause a bridge to fail.
Repair or Replacement Choices
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Bridge Crown Damage
Severe Porcelain Chip |
Repairing a broken bridge that involves the loss or damage to porcelain materials can be extremely difficult or impossible. Failure that is related to leakage or anchor tooth issues usually requires replacement (see examples here).
Porcelain Failure: When a single bridge tooth becomes damaged, as represented in the adjacent photo series, repair may be possible, depending upon the dentist's access to advanced technologies and, perhaps more importantly, the training and experience of the dentist.
Prosthodontists, in general terms, possess post graduate training in the design, development and fabrication of prosthetics. The more recent or more frequent exposure to special treatment issues that Prosthodontists typically are involved with plays a key role in developing a creative solution that may not be apparent to General Dentists.
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| Exposed Bridge Framework |
As a Prosthodontic specialist, Dr. McFarland was able to design a fabrication hybrid for replacing the restorative porcelain for the patient's damaged bridge.
All of the porcelain material that comprised the damaged cosmetic crown was carefully removed with special instruments. The bridge was not removed. The original framework was exposed and prepared for the custom restorative product.
The adjacent photo shows the use of temporary acrylic materials that enabled the patient to continue wearing the bridge without risking further damage while the final restorative porcelain was being completed at the dental lab.
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| Temporary Acrylic Bridge Tooth |
During the chairside development of the temporary crown treatment, occlusal, sizing and color characteristics were adjusted as needed to assure the patient that the final porcelain materials would provide good aesthetic value but also assured that the occlusal plane would be maintained.
As can be seen in the adjacent photo, bite testing is performed (blue bite registration deposits) to assure proper distribution of biting forces across the entire bridge and on opposing teeth.
The original damage could have been caused by a technical failure during the fabrication process or it could have been caused by unbalanced occlusion. The patient's concern, as well as Dr. McFarlands concern, is that it doesn't become repeated.
Final Restoration
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| Bridge Crown Repair Hybrid |
The adjacent photo of Dr. McFarland's handcrafted "repair crown" reveals how a special cementation interface is incorporated (fused) into the new bridge crown. Adhesion properties are expected to be superior and will provide long term endurance.
Since the exposed bridge framework fits "into" rather than "onto" the crown hybrid, the effects of lateral forces are minimized and are well controlled, which can be a common factor in some crown or bridge failures.
Successful Repair
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| Successful Bridge Repair |
The last picture reflects the final restorative treatment. The custom bridge crown has been permanently cemented onto the bridge framework. All of the technical factors that "could" lead to treatment failure have been accounted for and controlled.
The patient is reminded of the usual concerns that all bridge wearers are advised of when first being treated with a fixed bridge.
All bridge patients, in general terms, need to be mindful of food preferences (some may need to be changed), biting and chewing habits, maintaining recommended oral hygiene habits, using teeth as a "tool" (biting and tearing open food packaging, for example), potential for clenching or grinding (awake or asleep) and attending to treatment needs of adjacent teeth (fillings, chipped teeth, odd orthodontic changes, etc).
Editorial Staff
Material and photos provided by:
Christopher McFarland, DMD
Atlanta Prosthodontist - Periodontist
2530 Lawrenceville Highway
Decatur - Duluth - Atlanta, GA
(770) 492-0256
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