Fixed Dental Bridges

A fixed dental bridge (fixed partial denture) replaces one or more missing teeth with an artificial tooth, or pontic, that is permanently joined to retainers cemented onto the adjacent natural teeth or implants. Unlike a removable denture, it is not taken out by the patient and restores the gap as a single rigid span.

Definition

A fixed dental bridge, or fixed partial denture, is a non-removable prosthesis that replaces missing teeth by connecting one or more pontics to retainers (crowns or wings) cemented or bonded onto abutment teeth or implants.

Scope

This topic covers the tooth-supported fixed bridge: its components, how it spans an edentulous gap, the main material options, and the survival and complication patterns reported for multiple-unit fixed prostheses. It is a reference-educational overview rather than clinical instruction.

Core questions

• How does a fixed bridge differ from a removable partial denture and from a single crown?
• What are the abutments, retainers, and pontics that make up a bridge?
• How do survival and complication rates of multiple-unit fixed prostheses compare with single crowns?

Key concepts

• Abutment, retainer, and pontic
• Span and connector
• Tooth-supported versus implant-supported fixed prosthesis
• Resin-bonded (Maryland) bridge
• Metal-ceramic versus all-ceramic bridge frameworks
• Biological versus technical complications
• Cumulative survival of fixed dental prostheses

Mechanisms

A bridge restores a gap by transferring the load of the replacement teeth through connectors into retainers seated on abutment teeth (or implants), which carry the additional occlusal force. Because the span behaves as one rigid unit, framework strength, connector dimensions, and the integrity of each cemented retainer all govern longevity; loss of retention at a single abutment or fracture of veneering ceramic are characteristic technical complications, while caries or pulpal change at an abutment are biological ones (Pjetursson et al., 2015; Goodacre et al., 2003).

Clinical relevance

Fixed bridges are a standard option for replacing a small number of missing teeth, and pooled reviews describe how their evidence is reported — including abutment-related biological events and framework or veneer failures (Pjetursson et al., 2015; Goodacre et al., 2003). This entry explains how bridge outcomes are summarised and is not a basis for individual treatment planning.

Epidemiology

Systematic reviews report high cumulative survival of tooth-supported multiple-unit fixed dental prostheses over multi-year observation, with technical complications such as veneering-ceramic fracture and loss of retention, and biological complications at abutment teeth, tabulated by material and configuration; all-ceramic and metal-ceramic frameworks show differing complication profiles (Pjetursson et al., 2015; Sailer et al., 2015).

Evidence & guidelines

The core evidence is a systematic review and meta-analysis of survival and complication rates of multiple-unit tooth-supported fixed dental prostheses by framework material (Pjetursson et al., 2015), read alongside the companion review of single crowns (Sailer et al., 2015) and a structured synthesis of fixed-prosthodontic complications (Goodacre et al., 2003).

Debates

All-ceramic versus metal-ceramic bridge frameworks

Reviews compare survival and complication rates of all-ceramic multiple-unit prostheses with the metal-ceramic standard; framework fracture and veneer chipping behave differently between materials, so the choice is indication-dependent rather than settled.

Seminal works

• pjetursson-2015-fdp2
• goodacre-2003

Frequently asked questions

What is the difference between a fixed bridge and a removable partial denture?

A fixed bridge is cemented permanently onto adjacent teeth or implants and is not removed by the patient, whereas a removable partial denture clips in and is taken out for cleaning.

What is a pontic?

The pontic is the artificial tooth in a bridge that fills the gap; it is connected to retainers seated on the neighbouring abutment teeth or implants.