Unlike dental implants which are surgically placed and integrate permanently into the jawbone itself, conventional dental bridges that are adhered onto natural teeth can sometimes be removed and recemented back into place by a dentist if necessary. Dental bridges typically involve metal frameworks fused with porcelain crowns that are permanently cemented onto abutment teeth adjacent to a missing tooth gap.
While bridges are intended for long-term permanent use, issues do occasionally arise that make temporary removal advisable or required. However, there are important considerations regarding when attempting to remove and recement a dental bridge is appropriate versus ill-advised.
The decision depends on factors like the current health and stability of the abutment teeth, reason for removal, integrity of bridge fit and bonding, and presence of new dental disease. Carelessly removing bridgework could result in damage to abutment teeth or the bridge appliance itself.
There are also some situations where attempting recementation is no longer prudent due to changes since initial bridge placement, and a new tooth restoration would be the better recommendation. However, when clinically indicated, properly removing and recementing a dental bridge by an experienced dentist can safely extend its functional lifespan.
Your dentist will advise you on whether bridge removal is recommended, and if recementation is possible or feasible compared to replacement:
Reasons for Removing a Dental Bridge
There are some circumstances in which a dentist may recommend removing the cement from a bridge to take it out:
- Dislodged or loose bridge – If cement seal fails, the bridge may fully or partially detach from teeth.
- Broken or damaged section – Fractured or cracked abutment teeth or bridge span may require removal to be repaired.
- Developing cavity – Potential decay spotted under an abutment crown necessitates bridge removal for access and treatment.
- Abutment looseness – If the abutment tooth has loosened due to gum disease, the bridge may be removed and the tooth stabilized as part of overall treatment.
- Impression needs – Sometimes new bridge impressions require having the current bridge taken out. It can then be re-cemented after.
Proper Technique for Removing and Recementing a Bridge
Bridges may only be removed and recemented when done properly to avoid damage. This process involves:
- Local anesthetic is administered to numb the area first.
- Gentle wedging tools carefully detach bonding between abutment crowns and bridge.
- Once freed, the dentist may lightly polish the bridge and teeth before precise recementation.
- New crown cement is applied and the bridge is seated back on prepared teeth correctly.
- Occlusion is checked and patient provided post-recementation care instructions to allow full bonding.
When Bridge Recementing is not Recommended
Bridges should not removed or recemented in the event of:
Decayed Teeth under the Bridge
Tooth decay can occur underneath the dental bridge, especially if proper oral hygiene is not maintained. Decay weakens the tooth structure, jeopardizing the bridge’s stability. If decay is detected, the bridge needs to be removed, and the decayed tooth treated. Depending on the extent of decay, the tooth might need a filling, crown, or in severe cases, extraction.
Fractured Teeth under the Bridge
Sometimes, teeth beneath the bridge can fracture due to trauma or untreated decay. Fractures compromise the structural integrity of the supporting teeth. If a fractured tooth is found, it might need a crown, root canal, or extraction. If the supporting teeth can’t sustain the bridge, alternative treatments like dental implants, removable partial dentures, or a new bridge design might be considered.
Mobility of Abutment Teeth
Over time, abutment teeth (teeth supporting the bridge) might become mobile due to gum disease, bone loss, or other dental issues. Mobile teeth can’t provide a stable foundation for the bridge. If teeth are mobile, they need to be evaluated. If mobility is significant, the bridge might need removal. Treatments like splinting, periodontal therapy, or extraction might be necessary.
Fragility of Abutment Teeth
Teeth weakened due to decay, previous large fillings, or root canal treatments can become fragile. These teeth can fracture easily, making them unsuitable for bridge support. If abutment teeth are fragile, they might require crowns, and in severe cases, extraction. Dental implants could be an alternative to support a bridge in such cases.
Poor Bridge Fit Due to Shifting Teeth
Over time, natural teeth movement can occur due to various factors, including age, orthodontic changes, or tooth loss in the same dental arch. If adjacent teeth shift, it affects the fit of the bridge. Ill-fitting bridges can lead to discomfort, bite problems, and compromised aesthetics. In such instances, the bridge might need to be adjusted or replaced to ensure proper alignment and function.
Patient Difficulty in Adjusting to Bridge Height Differences
If a bridge is recemented but alters the patient’s bite significantly, it can cause discomfort, difficulty in chewing, and speech issues. Some patients might find it challenging to adjust to these differences. It’s crucial for patients to communicate any discomfort to the dentist. Adjustments can be made to the bridge to enhance comfort and ensure proper occlusion. If the patient still struggles, a new bridge design might be necessary, considering the patient’s comfort and functionality.
If the abutment teeth or the surrounding gums have developed periodontal disease, it might compromise the stability of the bridge. Removing and recementing the bridge without addressing the underlying gum disease can lead to further complications.
Significant bone loss around the abutment teeth might weaken their foundation. In such cases, additional dental procedures, like bone grafting, might be necessary to provide adequate support for the bridge.
Over time, the materials used in bridges, such as porcelain or metal alloys, might deteriorate. If there are signs of wear, chipping, or corrosion, it’s an indication that the bridge may need replacement rather than a simple recementation.
Teeth grinding (bruxism) or jaw clenching
This condition can exert abnormal forces on the bridge. If the bridge has been damaged due to these forces, recementing without addressing the cause could lead to recurrent damage.
If the bridge affects the bite alignment (occlusion) and the patient is experiencing discomfort or difficulty in chewing, it indicates a problem with the bridge’s fit. A remake might be necessary to ensure proper alignment and function.
Speech or Eating Difficulties
Patients experiencing speech difficulties or challenges in eating certain foods due to the bridge’s design or height differences might require adjustments or a new bridge design to enhance comfort and functionality.
If the bridge is several years old, advances in dental technology may offer more durable and aesthetically pleasing options. Patients might opt for a new bridge to benefit from the latest materials and techniques.
Patients might desire a bridge with a more natural appearance or a different shape. Addressing cosmetic concerns could require a new bridge design.
Better Alternative Treatments
Depending on the patient’s overall oral health, dental implants or other advanced restorative solutions might be more suitable alternatives. Exploring these options with the patient can guide the decision-making process.
In many of these cases, the wiser option is a new bridge rather than trying to recement the old one.
When clinically indicated, permanently cemented bridges can be safely removed and recemented by a dentist to restore loose or damaged restorations. However, this is not advised in all circumstances if teeth or fit are compromised. Discussion between dentist and patient determines when recementation is appropriate or when replacement is the smarter option.
Moreover, regular dental check-ups are essential. These appointments allow dentists to monitor the condition of bridges, identify issues early, and provide timely recommendations to maintain optimal oral health.