A dental bridge is used to replace one or more missing teeth. It fills the gap made by the missing teeth and is supported on both sides by the existing natural teeth or implants. Traditionally, bridges have been made using a metal framework with porcelain fused on top. But nowadays, zirconia is becoming a popular material for bridges due to its strength, aesthetics, and biocompatibility.
What is zirconia?
Zirconia, also called zirconium oxide, is a ceramic material that is very strong and durable. In dentistry, zirconia is used to make dental crowns, bridges, implant abutments and more.
The zirconia used in dentistry is stabilized zirconium oxide which has exceptional fracture toughness and strength properties. It is a tooth-colored material that offers lifelike aesthetics.
Why choose zirconia bridges?
Zirconia bridges have become a top choice for both dentists and patients due to the following reasons:
Exceptional strength
The exceptional strength of zirconia makes it very reliable for dental bridges. Zirconia is stronger than other metals and ceramics used in dentistry. Traditionally, metal-ceramic bridges with porcelain fused to a metal framework were used. But nowadays solid zirconia bridges made of a single piece of zirconia offer superior strength and durability. Such full-contour zirconia bridges have exceptional fracture resistance.
Aesthetic appeal
With zirconia bridges, the entire bridge framework as well as the crowns over the implants/teeth are made of tooth-colored zirconia. This offers a highly aesthetic and natural appearance, unlike metal bridges where the metal may show as a dark line at the gum. The zirconia bridge is customized to match the natural shade of the patient’s teeth for a seamless smile.
Biocompatible
Zirconia is highly biocompatible and does not trigger allergenic reactions. It avoids common metal allergies seen with certain traditional metal alloys used in bridges and crowns. As it does not contain metal components, a zirconia bridge is safe for the gums and body tissues.
Long-lasting
Well-made zirconia restorations are very durable and offer extended service life. Studies show that all-zirconia bridges have a 94% chance of survival without chipping or fractures over 10 years. With proper care and maintenance, zirconia bridges can last for over a decade.
Zirconia Bridges in Dentistry: Types of bridges using zirconia
There are a few types of bridges than can be made using zirconia:
Monolithic zirconia bridges
These are full-contour bridges milled out of a solid block of zirconia with no porcelain overlay. This type offers maximum strength as they avoid chipping or fracture risks seen with traditional two-layer zirconia bridges. The monolithic bridges also offer better longevity and excellent aesthetics. These are more expensive than porcelain-fused-to-metal bridges but are an excellent long-term investment considering their exceptional performance.
Two-layer zirconia bridges
In this type, the bridge framework is made of zirconia, and then natural-looking porcelain is layered to resemble the appearance of natural teeth. These bridges offer a great combination of strength, durability as well as natural aesthetics owing to the porcelain.
When properly designed and fabricated by an excellent dental lab, these bridges offer reliable long-term function. However, these are more prone to chipping of porcelain as compared to full-contour zirconia bridges.
Zirconia-composite bridges
This is made using a zirconia framework which is then layered using a composite resin material. These bridges are comparatively more affordable but have higher risks of fracture and wear of the composite material with time. An experienced dentist can evaluate risks and benefits before suggesting this economical option.
When should zirconia bridges be avoided?
While offering some great advantages, zirconia bridges also have limitations in certain clinical situations:
Extensive gaps
For multiple missing teeth, especially when more than 3 adjacent teeth need to be replaced, removable dentures may be a better solution than extensive bridges. This avoids placing excessive biting force on the supporting natural teeth or implants.
Unhealthy gums or bone loss
In cases of advanced gum disease that leads to severe bone loss, removable full or partial dentures may be the safer choice than bridges with crown preparation.
Severe grinding/clenching
Patients with a long history of severe teeth grinding or clenching habits are at higher risk of damaging/fracturing zirconia bridges as compared to removable dentures.
If any of the above factors are involved in a case, a skilled cosmetic dentist can suggest suitable alternative solutions. Removable dentures, partial dentures, or dental implants with crowns are options that should be explored.
The process of getting zirconia bridges
The basic steps are briefly outlined below:
- Impressions: The dentist will take impressions of the area needing restoration. These impressions capture the surface details and shape which are then used by the dental lab to create a precision restoration.
- Custom shade selection: The dentist measures tooth color using a digital shade guide to create and match crowns/bridges to surrounding natural teeth.
- Temp bridge: A temporary bridge is placed to protect the prepared teeth or cover gaps from missing teeth while the permanent zirconia bridge is being made.
- Custom design and fabrication: The dental lab creates an accurately fitting zirconia substructure for strength and then layers elite quality ceramics mimicking natural tooth appearance and vitality. The bridge is designed to evenly distribute biting force.
- Delivery: In the next appointment, the dentist fits and adjusts the zirconia bridge for optimal function and seamless beauty. The patient is also counseled on proper bridge care and maintenance needs.
Comparison to other options
Here is how zirconia bridges compare to some other tooth replacement options:
- Zirconia Bridges Vs Implant Bridges: Dental implants offer the most predictable long-term solution for missing teeth. And implant-supported bridges help in avoiding the need to drill healthy teeth crowns.
However, implants involve surgery and are also costly. And so for patients who need an alternative to implants mainly because of health/budgetary reasons, zirconia bridges present an alternative solution. - Zirconia Bridges Vs Removable Partial Dentures: Partial dentures are a more affordable option when it comes to replacing multiple missing teeth. However, they require excellent compliance from patients, especially with regards to daily denture care and wearing protocols. On the other hand, Zirconia bridges offer a fixed, hassle-free solution that leads to better comfort and tissue health.
- Zirconia Bridges Vs PFM Bridges: The traditional PFM (porcelain fused metal) bridges have demonstrated clinical success over decades, but with modern advances, solid zirconia bridges offer superior longevity and excellent aesthetics. The biocompatibility is also better with the metal-free zirconia material.
Tips for success with zirconia bridges
Here are some useful tips to help you get it right when it comes to selecting and using zirconia bridges:
- Select an experienced dentist with advanced skills in zirconia restorations for the precision design and customized fabrication of the bridge by their qualified lab technicians. This ensures optimal accuracy, strength durability as well as flawless aesthetics of the final restoration.
- Maintain excellent oral hygiene to prevent decay or loosening of bridge attachments. Regular dental visits allow early detection of any issues.
- Protect the bridge from very hot fluids or sudden temperature extremes. Avoid chewing excessively hard foods like nuts, candies or ice cubes which increases the risks of cracking or debonding.
So in summary, zirconia offers exceptional advantages in terms of strength, durability, biocompatibility as well as lifelike aesthetics for dental bridges. When properly designed and fabricated, zirconia bridges present an excellent tooth replacement solution for many patients.
However certain clinical precautions must be considered before recommending zirconia bridges as the ideal choice. With customized care and excellent home maintenance, zirconia bridges can offer many years of stress-free use.
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