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New York Reconstructive Bridgework Dentistry

Affordable Cosmetic Tooth Replacements

Non implant supported bridgework is one of the most popular and affordable treatment choices for patients who want tooth replacement that offers great looks, feels and appears natural (matches adjacent teeth perfectly).

Single Unit Maryland Bridge
Dr. Koeppel provides a large menu of choices for patients who want to replace one tooth... or several. Zirconia, Lava, Procera, all porcelain, high noble gold metal and the popular Maryland Bridge can be used to create or recreate nearly any cosmetic and functional outcome desired.

Maryland Bridge

Maryland bridges can be 100% ceramic or they can have metal components that provide the cementation surface that typically is attached to the lingual sides of adjacent teeth.

Custom Single Tooth Bridge
Single Unit Maryland Bridge
A major appeal of this type of bridgework is that adjacent teeth do not require over-prepping of adjacent teeth. Neighboring tooth structures are not shortened to accommodate an anchoring crown that supports the bridge unit.

Dr. Koeppel recommends the use of this type of bridge because of its minimally invasive qualities and in particular, for its value in permitting patients to "upgrade" this type of bridge into a dental implant treatment at a later date.

Since no significant tooth preparation is performed on adjacent teeth, the expense and complexity of treatment is much less since there are no "anchor teeth" that need to be re-treated.

Metal versus All Ceramic Bridge

Depending on the location of the teeth needing a bridge replacement, Dr. Koeppel determines, based on a patients particular "bite dynamics", what type of framework will function best.

In general terms, a metallic framework offers more functional durability than a porcelain or ceramic (includes zirconia) bridge. But.... a ceramic bridge is better suited to provide superb cosmetics.

Dr. Koeppel all but eliminates the common errors associated with selecting the wrong framework material. Occlusion forces are evaluated for each individual patient which creates the data used for creating the framework that provides the best combination of bridge cosmetics and long term bridge function.

Patients who have unusually high occlusal forces in a location of the jaws that have high cosmetic value (teeth can be easily seen in a broad smile) are often recommended to have a high noble gold alloy framework.

The porcelain layering (creation of cosmetic teeth) on a gold alloy produces functional tooth structures with cosmetic qualities that beautifully match other natural teeth in the arch. No ugly gray or black metal "effects" can occur, ever.

Gold alloys eliminate the probability of an all porcelain bridge framework that can "fail by surprise" due to unanticipated occlusal forces. Patients who suspect having unusual bite characteristics can be evaluated to assure the best bridge framework is selected.

Posterior bridges (tooth replacements for rear areas of jaws) are routinely made of gold metallic alloys to provide the strength and durability needed to function well regardless of the biting and chewing forces a patient may have.

Lava Zirconia Porcelain Bridge

Advanced polymers and premium porcelain layering can be combined to create spectacular cosmetics that many patients prefer for eliminating the concern about metallic frameworks being seen or "felt".

All ceramic bridges are also a favorite of patients who have unusual ability to taste metallic components of dental restoration products. Patients who have issues with tasting fillings, PFM crowns and other restorative items are evaluated for bridgework that eliminates this issue.

Endurance and Longevity

Statistically, cemented bridgework used for replacing a span of 2-3 or more teeth does not endure as long as an implant supported bridge.

In real life however... the endurance issue is highly variable. Due primarily to how a patient maintains good oral health habits... a bridge can fail in just a few years.... or they can function well with good cosmetics for as long as 30 years.

The major factors that affect cemented bridge products include, in ranked order: bacteria build up at anchor teeth area, amount of bone resorption (if any) near anchor teeth locations, dietary habits, occlusal forces, length of span and number of intermediary support structures (healthy tooth structure in the middle of a span prepped as an additional anchor).

Patients who have excellent oral health habits typically do well with cemented bridge products. Scheduled routine office visits provide added assurance of maintaining bridge longevity.

Patients who do not maintain healthy bridge maintenance habits predictably experience the need to replace bridges after several years. As outlined above, bacteria build up, eventual leakage and torque forces will cause decay to occur on the anchor teeth which, in turn, can cause the bridge to become loose or literally fall off.

To assure the wisest use of resources and the conservation of treatment, Dr. Koeppel evaluates each patient to assure they select the best bridge product that matches their oral hygiene and bite characteristics. For most patients this extra attention to detail minimizes the possibility of having complex bridgework fail when it shouldn't fail.

Implant Supported Bridges

Some patients are recommended for implant supported bridgework. Dental implants, the Gold Standard of Tooth Replacement, provide additional rock solid structural characteristics that some bridgework candidates may need to consider due to the potential of failure factors (outlined above) occurring.

The common horror stories of an expensive bridge failing (becoming loose, falling off, tastes funny, causes pain, etc) in a very short time usually reflects the selection of an incorrect bridge product.

Dr. Koeppel collects a variety of data during and after the comprehensive exam consult which is used to evaluate the number of choices patients can have for making selections of treatments, procedures and products that can provide the endurance each patient wants, without unnecessary expense.

Patients with tooth replacement needs that are being caused by complicated dental condition should review our material on Implant Supported Bridges for more technical information.


Call our office at 631-689-1800 to schedule a consult to learn more about the different choices of products and technologies Dr. Koeppel provides patients who are considering dental bridges.

Patients with specific questions about bridgework dentistry or additional conditions are invited to contact Dr. Koeppel directly with our on-line Ask The Dentist form. Dr. Koeppel will respond directly with the answers and information you are seeking.

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New York Reconstructive Dentist
Ira Koeppel, D.D.S.
126 Gnarled Hollow Road
East Setauket Long Island New York NY 11733
Nassau - Suffolk County Spa Dentistry