Choosing the Right Dental Bridge Material: Zirconia vs. Metal Options

Regarding the materials used for dental bridges and inquiries about "hygienic dental bridges."

I would like to ask everyone, I am currently getting a dental bridge and initially wanted to have a full zirconia crown, but my dentist recommended a semi-precious metal crown (which can be porcelain-fused) instead.
The reason is that if a full zirconia crown accidentally bites down on something too hard, there is a possibility that the dental bridge could break, while metal would not have that issue.
However, I am concerned that over time the gums may turn black.
The dentist mentioned that the fit of the semi-precious metal crown is good, with a low chance of marginal leakage, and that the gums may not necessarily turn black; there might just be a shadow of the metal showing under light.
Additionally, in the area from the first premolar to the second molar, it is not visible and will not affect aesthetics.
What do you all think? Is the dentist's recommendation correct?
Furthermore, since the dental bridge will be placed in a location that is not visible, I plan to discuss with the dentist the possibility of creating a "hygienic bridge," which would leave a small gap between the middle tooth and the gums below for easier cleaning.
This is to prevent future issues with food debris that could lead to cavities in the adjacent teeth.
Does anyone have experience with this "hygienic bridge"? I would like to know if there are any other drawbacks besides aesthetic concerns.
I initially considered getting an implant, but I have a congenitally missing second premolar (I am now 32 years old).
I only had about one-tenth of a baby tooth that was stuck there, and the tooth above it had already descended significantly, causing some tilting of the adjacent teeth.
Previous X-rays showed no permanent tooth hidden there.
Due to the significant height difference between the teeth, food often got stuck in the gaps, and my inadequate care led to gum inflammation and abscesses.
Therefore, I had that baby tooth removed five years ago.
Now, without that baby tooth, the adjacent teeth have started to tilt even more towards the center, so I decided to address this issue.

After examination, the dentist presented two options: first, to get a dental bridge, which is simpler, by reducing the size of the adjacent teeth and placing crowns on top, while creating the bridge below; second, to get an implant, which is more complicated due to insufficient space for the implant and the misalignment of the adjacent teeth that would require orthodontic treatment.
The tooth that has descended is particularly difficult to correct, and there is no guarantee of success.
Overall, both time and cost would be quite high, so I opted for the dental bridge.
I am currently undergoing treatment, having already reduced the size of three teeth, and I have one tooth left that requires root canal treatment.
After that, I will need to decide on the material for the crowns.
The dentist said that using full zirconia for the upper crown is fine, but there are the aforementioned concerns regarding the dental bridge.
I would like to hear everyone's opinions.
Thank you!

Huang Xue Ri, 30~39 year old female. Ask Date: 2021/04/01

Dr. Zeng Guanghui reply Dentistry

1.
Considering strength issues, it is recommended to use traditional metal-ceramic crowns, while for the bridge, it is advisable to use a hygienic dental bridge for easier cleaning and maintenance.
2.
If a single crown is needed, a full zirconia crown can be used.
Dr.
Tseng Guang-Hui, Department of Dentistry, Nantou Hospital.

Reply Date: 2021/04/01

More Info

When considering the right dental bridge material, particularly between zirconia and metal options, there are several factors to take into account, especially given your unique dental history and current situation.

Material Options: Zirconia vs. Metal
1. Zirconia Bridges:
- Strength and Durability: Zirconia is known for its strength and resistance to wear. It is less likely to fracture under pressure compared to porcelain alone. However, it can be brittle, and if subjected to excessive force (like grinding or clenching), it may still break.

- Aesthetics: Zirconia offers excellent aesthetics, closely mimicking the natural tooth color. This can be particularly beneficial if the bridge is in a visible area.

- Gum Health: Zirconia is biocompatible, meaning it is less likely to cause allergic reactions or gum irritation. It does not cause the darkening of the gums, which can occur with some metal options.

2. Metal Bridges (including Semi-Precious Metals):
- Strength: Metal bridges, particularly those made from semi-precious or precious metals (like gold or palladium), are incredibly strong and can withstand significant biting forces. This makes them a good choice for areas with high occlusal pressure, such as molars.

- Longevity: Metal bridges tend to have a longer lifespan compared to porcelain or zirconia, especially in patients with a history of grinding or clenching teeth.

- Aesthetic Concerns: One downside is that metal can sometimes show through the gums, leading to a dark appearance, especially if the gums recede over time. However, in non-visible areas, this may not be a significant concern.

Recommendations Based on Your Situation
Given your history of dental issues, including multiple failures of previous bridges and your noted grinding habit, a metal bridge may be more suitable for you. The strength of metal can provide the durability you need, especially in the back teeth where the forces are greatest.
However, if aesthetics are a concern and the bridge is in a visible area, you might consider a zirconia bridge for its natural appearance. Discuss with your dentist the possibility of using a combination approach, where metal is used for strength in areas of high stress, while zirconia is used for aesthetic purposes in more visible areas.

Hygiene Considerations: The "Hygienic Bridge"
The concept of a "hygienic bridge," which leaves a small gap between the bridge and the gums, can be beneficial for cleaning. This design can help prevent food accumulation and reduce the risk of decay in adjacent teeth. However, there are potential downsides:
- Food Trapping: While it can aid in cleaning, it may also allow food particles to become trapped if not properly designed.

- Aesthetic Concerns: Depending on the gap's size and location, it may affect the overall appearance of your smile.

- Support: Ensure that the remaining teeth can adequately support the bridge without compromising their health.

Conclusion
Ultimately, the choice between zirconia and metal for your dental bridge should be made in consultation with your dentist, considering your specific dental needs, aesthetic preferences, and oral hygiene practices. Given your history of dental issues, a strong, durable material that can withstand your bite force is crucial. Discuss the possibility of a hygienic bridge design with your dentist to ensure you maintain optimal oral health while addressing your aesthetic concerns.

Similar Q&A

Choosing Durable Dental Bridge Materials: Expert Recommendations for Long-lasting Solutions

Dear Doctor, I would like to ask you some questions. When I was a child, I did not brush my teeth, which led to many cavities. After getting several dental prostheses, most of them lasted for over a decade. However, the dental bridge on the lower left side (missing the first mol...

Dr. Lin Jiayong reply Dentistry
Hello: If there is a strong bite force and a habit of teeth grinding, it is recommended to use metal crowns or bridges with a higher gold content. Additionally, a night guard can be used to protect the joints and muscles. Thank you!

Is Choosing Metal-Ceramic Bridges for Molars a Good Option?

Hello, I would like to ask about getting a dental bridge for my left posterior molar area. I chose a metal-ceramic bridge, and the dentist suggested that the first two units be porcelain-fused-to-metal while the third unit should not be porcelain-fused. He mentioned that this wou...

Dr. Zeng Guanghui reply Dentistry
Hello: If you need to get a dental bridge and the molar teeth do not have sufficient brightness or tooth structure, you may consider getting a metal crown to avoid excessive reduction of tooth structure, which could affect the dental nerves. Dr. Tseng Guang-Hui, Department of Den...

Choosing the Right Dental Post: Zirconia, Fiber, or Precious Metal?

I am about to start getting all-ceramic crowns. Currently, I am at the stage of placing the posts (after completing root canal treatment). The options I have are zirconia posts (computer-generated), fiberglass posts, metal posts, or precious metal posts. The doctor mentioned that...

Dr. Zhuang Suhui reply Dentistry
Hello: Different materials for nails have varying properties and hardness. Of course, when the material of the nail is hard, it can potentially cause root fractures. However, sometimes we need to rely on its hardness to support the teeth. Therefore, the selection should still dep...

Choosing the Right Material for Your Dental Crowns: Porcelain vs Zirconia

Hello Doctor: My front tooth and lateral incisor (a total of two teeth) were impacted in a car accident a month ago, resulting in necrosis of the dental tissue. I have undergone root canal treatment. Although the shape of the teeth is intact, there are cracks on the surface and i...

Dr. Huang Tingfang reply Dentistry
Dear Ms. Crutch Person, Hello! If it is just a dental crown, a full ceramic crown is generally sufficient; however, if you need a dental bridge, consider using zirconia! Please communicate more with your dentist. Thank you! Wishing you safety! Sincerely, Dr. Huang Ting-Fang, ...