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Compare and Contrast: Dental Implants and Bridges

By

Edith Gonzalez and Julia Nguyen

In partial fulfillment

of the requirements for

Seattle Central College

AHE 401: Research Methods

Ms. Gina Dunn, RDH, BSDH, MSDH

June 7, 2023
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In dentistry, the replacement of missing teeth goes beyond aesthetic concerns. It plays a

crucial role in restoring oral functionality and preventing potential complications. When there is

a missing tooth, the neighboring teeth may gradually shift or tilt into the gap, disrupting the

alignment of the dentition. This can lead to bite problems, difficulty in chewing, and increased

attrition and abrasion on the remaining teeth (Flanagan, 2017). Two solutions commonly

recommended treatment options are dental implants and dental bridges. Both implants and

bridges offer effective ways to fill the gaps left by missing teeth, but differ in procedures,

durability, maintenance, and cost. This essay aims to compare dental bridges and implants,

highlighting their advantages and limitations.

Procedures

Both dental implants and bridges serve the purpose of replacing missing teeth, but they

have different approaches. Dental bridges are a popular tooth replacement option which involves

creating a pontic, or false tooth, supported by two adjacent teeth, called abutments. The

neighboring teeth are prepared by removing a two-millimeter layer of enamel to fit the crown

supporting the bridge (Boyd et al., 2021). However, this is a disadvantage of bridges compared to

implants. The removal of healthy enamel can potentially weaken the abutments, increasing the

risk of caries or damage in the long run. Following the preparation of the bridge, a custom bridge

is created and cemented onto the abutment teeth. One notable advantage of dental bridges over

implants is their shorter treatment time and do not require surgery. Because bridges do not

require surgery, bridges may be placed in areas with bone loss. Dental bridges rely on the

neighboring teeth for support while dental implants require the alveolar bone for support.

Therefore, implants require a certain amount of bone to be placed.

On the other hand, implants are a prosthetic that closely resemble a natural tooth, with a

root-like structure implanted into the alveolar bone and topped with a crown that functions like a
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real tooth (Boyd et al., 2021). It requires a surgical procedure done in multiple appointments. The

process begins with the placement of the implant root into the alveolar bone, serving as the

foundation of the crown. After the implant is placed, it takes on average 6-7 months to integrate

with the alveolar bone called osseointegration (Esposito et al., 2012). Compared to bridges,

implants have a disadvantage of a longer healing time and procedure. However, a significant

advantage of implants are they eliminate the need for preparing the adjacent teeth.

Durability

With proper care, dental bridges can last on an average lifespan of 10-15 years. However,

it is important to note the longevity of the bridge is influenced by factors such as the health of the

abutments and quality of the bridge itself. Similarly, research indicates, “the long-term implant

cumulative survival rates up to 16 years” (Simonis et al., 2010). However, as implants have

gained popularity, there has been an increase of peri-implant diseases, which is the inflammation

of the gums and/or supporting tooth structures of the implant (Jepsen et al., 2015). Peri-implant

diseases affect the durability of implants due to bone loss, implant instability, and potential

implant failure over time. In comparing implant and bridge durability, poor oral hygiene and

excessive forces on bridges and implants can significantly impact the durability and lifespan of

both prosthetics.

Maintenance

All things considered, a comprehensive maintenance protocol should be followed to

ensure the longevity of an implant or bridge (Gulati et al., 2014). Once a dental implant or bridge

has been placed, routine dental appointments, recall evaluations and radiographs are required for

proper evaluation. To begin with, a typical maintenance appointment for patients with dental

implants should be approximately one hour and scheduled every three months to assess any

changes in their oral and overall history (Gulati et al., 2014). The overall long-term success of
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implants is dependent upon both the patient’s maintenance of proper home care and professional

hygiene care. In addition, the health of the implant’s hard and soft tissues is an important factor

in the long-term success of an implant. Regarding dental settings, clinicians must ensure “to have

a proper instrument selection to prevent damage to the implant surface and trauma to the peri-

implant tissues” (Gulati et al., 2014). During dental appointments clinicians are advised to assess

the following on peri-implants: plaque and mucosal assessment, peri-implant probing depth,

width of peri-implant keratinized mucosa, peri-implant sulcus fluid analysis, suppuration,

occlusal evaluation, radiographic evaluation, and evaluation of implant mobility (Gulati, et al.,

2014).

In relation to dental bridges, the long-term success is also dependent on the patient’s

maintenance of proper home care and professional hygiene care – as those who have implants.

Nonetheless as mentioned above, dental bridges hold a different role in the oral cavity compared

to implants. In contrast, patients with dental implants benefit from visiting their dentist and

dental hygienist at the minimum three times a year for proper continuing care depending on

patient compliance and risk factors (Geiballa et al., 2016). Set side by side, the performance of a

bridge “is evaluated by measuring outcomes of chewing, function, esthetics, longevity, as well as

technical complications” (Geiballa et al., 2016). In summary for these two supported

restorations, it is important patients are properly educated about the importance of maintaining a

proper oral health routine and understand the challenges of maintaining these restorations before

establishing a treatment plan for a tooth replacement.

Cost

In connection to the financial portion of a dental implant and bridge, they both

dramatically differ from one another. Although dental implants were introduced 25 years ago and

are considered a new and reliable technique compared with bridges - studies currently show that
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it is difficult to recommend one treatment option over the other (Bouchard et al., 2009). Every

patient has a unique treatment case and many desire a different outcome than other cases, that is

why it is important to confirm the patient’s needs prior to beginning treatment.

In relation to the overall cost of an implant compared with bridges is a “limiting factor for

their spread to the general population” (Bouchard et al., 2009). The treatment plan of an implant

is expensive, in terms of equipment, maintenance and training. Cost effectiveness analysis plays

an important factor in the decision-making process for patients. A study titled “Cost-effectiveness

modeling of dental implant vs. bridge" by Bouchard et al., assessed and compared the cost-

effectiveness of implants and bridges. During the five-year research study, it was determined if a

bridge is not successful within the first five years, the patient would need to invest in a new

bridge, double-implant, or removable partial denture. Whereas if an implant is not successful

within the first five years the patient is automatically required to invest in a new implant. All in

all, the result of this study demonstrated that dental implant surgery for the replacement of one

missing tooth is the most beneficial. Though implant research and development are currently

very active – it has been stated that there is not a possibility manufactures would consider

lowering the cost of an implant in the future (Bouchard et al., 2009). Therefore, will continue to

affect a patient’s ability to consider an implant as part of their treatment plan.

Conclusion

In conclusion, dental bridges and dental implants are both vital options for replacing

missing teeth, each with its own set of advantages and limitations. It is important for dental

health care providers to discuss the similarities and differences of each prosthesis to educate

patients. Dental health care providers must consider individual patient factors such as adhering to

oral homecare, alveolar bone level, patient preferences, and price budget to help patients to make

a well-informed decision.
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References

Bouchard, P. J., Renouard, F., Bourgeois, D., Fromentin, O., Jeanneret, M., & Beresniak, A.

(2009). Cost-effectiveness modeling of dental implant vs. bridge. Clinical Oral Implants

Research. https://doi.org/10.1111/j.1600-0501.2008.01702.x

Boyd, Linda D., Mallonee, Lisa F., and Charlotte Wyche. (2021). Wilkins’ clinical practice of the

dental hygienist (13th ed.). Jones & Bartlett Learning.

Esposito, M., Maghaireh, H., Grusovin, M. G., Ziounas, I., & Worthington, H. V. (2012).
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Interventions for replacing missing teeth: management of soft tissues for dental

implants. The Cochrane Database of Systematic Reviews, 2012(2), CD006697.

https://doi.org/10.1002/14651858.CD006697.pub2

Flanagan D. (2017). Bite force and dental implant treatment: a short review. Medical Devices

(Auckland, N.Z.), 10, 141–148. https://doi.org/10.2147/MDER.S130314

Geiballa, G. H., Abubakr, N. H., & Ibrahim, Y. E. (2016). Patients’ satisfaction and maintenance

of fixed partial denture. European Journal of Dentistry, 10(02), 250–253.

https://doi.org/10.4103/1305-7456.178313

Gulati, M., Govila, V., Anand, V., & Anand, B. (2014). Implant maintenance: A clinical update.

International Scholarly Research Notices, 2014, 1–8.

https://doi.org/10.1155/2014/908534

Jepsen, S., Berglundh, T., Genco, R., Aass, A. M., Demirel, K., Derks, J., Figuero, E.,

Giovannoli, J. L., Goldstein, M., Lambert, F., Ortiz-Vigon, A., Polyzois, I., Salvi, G. E.,

Schwarz, F., Serino, G., Tomasi, C., & Zitzmann, N. U. (2015). Primary prevention of

peri-implantitis: managing peri-implant mucositis. Journal of Clinical Periodontology, 42

Suppl 16, S152–S157. https://doi.org/10.1111/jcpe.12369

Simonis, P., Dufour, T., & Tenenbaum, H. (2010). Long-term implant survival and success: a 10

16-year follow-up of non-submerged dental implants. Clinical Oral Implants Research,

21 (7), 772–777. https://doi:10.1111/j.1600-0501.2010.01912.x