Fixed Dental Bridge: How It Works, Types and Bridge vs Implant

By Dr. Cléo Salustiano · CRO-SP 170844

08 Nov 2026 · 8 min read

Updated 08 Nov 2026

A fixed dental bridge is a prosthesis that replaces one or more missing teeth using the teeth next to the gap (or implants) as support, and it is cemented in place, so the patient does not remove it. It is usually considered when a few teeth in a row are missing and the teeth beside the gap are firm, with healthy gums and bone. The main drawback of a conventional bridge is that the supporting teeth have to be reduced to receive crowns, so choosing between a bridge and an implant depends on each mouth.

This article focuses only on fixed bridges: how they are made, the main types, how to care for them and when they make more sense than a single implant. To compare all prosthetic options (fixed, removable and full-arch), see the guide fixed vs removable vs full-arch implant denture. For the broader comparison between implants and dentures, read dental implant vs denture.

Dr. Cléo Salustiano (CRO-SP 170844), a dentist in Mooca, explains the step-by-step process, the hygiene habits that make a difference to how long a bridge lasts, and the signs that it is time to have it checked.

This article comes from Dr. Cléo Salustiano's dental office in Mooca, São Paulo (care in English, Portuguese and Spanish). See the dental implants page to learn how the treatment is done here and book your assessment.

How a fixed bridge works and the main types

A fixed bridge has two main parts. The abutments are the teeth (or implants) on each side of the gap, which receive crowns. The pontic is the artificial tooth that sits where the missing tooth was, attached to the abutment crowns like a bridge between two banks. In a three-unit bridge, for example, two supporting teeth hold one artificial tooth in the middle. Chewing forces are shared by the abutments, so they need to be healthy and well supported by bone.

Conventional bridge: the most common type. The teeth beside the gap are prepared (reduced) to receive crowns, which are joined to the artificial tooth. It can be made of porcelain fused to metal, zirconia or all-ceramic materials, depending on the area of the mouth, bite force and the look you want. It is a sensible option when the supporting teeth already have large fillings or would need crowns anyway, because the reduction then serves a need that already existed.

Resin-bonded (Maryland) bridge: it has small "wings" bonded to the back of the neighboring teeth, with minimal or no reduction. It is used mainly to replace a front tooth when the bite allows, and sometimes as a transitional solution. It needs a good bonding surface and can debond over time, but it preserves the structure of the neighboring teeth. There is also the cantilever bridge, supported on one side only, used in specific situations and with extra attention to bite forces.

Implant-supported bridge: when several teeth in a row are missing, two or more implants can hold a bridge without involving natural teeth. This is different from placing one implant per tooth and also different from a full-arch prosthesis, which replaces the whole arch. Before any bridge, the dentist examines the mouth, checks gums, decay, previous root canals and the bite and, when needed, requests X-rays or a CBCT scan to assess the bone and the roots of the supporting teeth.

Steps, care and when to choose a bridge or an implant

Typical steps for a conventional bridge: assessment and planning; treating whatever is needed first (decay, gums, sometimes a root canal on an abutment); preparing the supporting teeth under local anesthesia; impressions or digital scanning; a temporary bridge to protect the teeth and keep your smile; a try-in of the framework and shade; and final cementation with bite adjustment. The number of visits varies with the case and the material. Some sensitivity in the prepared teeth during the first days is normal.

Hygiene matters most for how long a bridge lasts. Because the artificial tooth rests against the gum, plaque builds up underneath it and around the crown margins, and a toothbrush alone does not reach there. Regular floss cannot pass between joined units, so you need a floss threader, floss with a stiff end, interdental brushes or a water flosser, as your dentist advises. The most frequent problems with older bridges are decay at the edge of the abutment crowns, gum inflammation and, sometimes, the need for a root canal on a supporting tooth. Regular checkups and professional cleanings help catch these problems early.

Bridge or implant? In general terms, a single implant is usually considered when the neighboring teeth are intact, because it does not require reducing them, and when there is enough bone and the patient's health allows surgery. A bridge may make more sense when the neighbors already need crowns, when surgery is not possible or not wanted, when bone is insufficient and a graft is not desired, or when a shorter treatment time is important. There is no single answer: the decision depends on the exam, the bite, hygiene and the patient's priorities. Leaving the gap empty for a long time also has consequences, such as neighboring teeth tilting and the opposing tooth drifting down.

This content is for information only and does not replace an assessment. Consult a dentist if your bridge feels loose, smells bad, the gum around it bleeds or it hurts to chew. In Mooca, Dr. Cléo Salustiano sees patients every day, from 8 a.m. to 10 p.m., including Sundays and holidays, at her dental office in Mooca, including dental implants, and helps you compare a bridge and an implant for your case.

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