In more complicated cases of aesthetic treatments or major tooth structure destruction, such as after a root canal, we install a crown on the tooth to restore its integrity and its initial strength. The preparation of the tooth is more important than in the case of a veneer, but we can correct much more complex cases. Traditionally, crowns were made of yellow gold, then came the crowns covered with acrylic and later porcelain. Nowadays, we try to use all-porcelain crowns to get an exceptionally cosmetic result with the strength and consistency of gold crowns.
A bridge is a structure cemented onto the remaining teeth to replace missing teeth. The supporting teeth, called pillars, are reduced in size to receive the structure. We use a gold frame for support and the outer layer is made of porcelain for aesthetic purposes. Complete porcelain bridges made without any metal can be made but they tend to fracture in extensive cases. A typical example of the use of bridges would be that of a young patient wearing partial dentures for several years but is not comfortable with them (often due to the fact that they must be removed at night).
Bridges allow a stationary structure to replace the missing teeth. The major problem with bridges is their longevity, since the function of the missing tooth is distributed on the two pillars, the load-bearing teeth may developsome complications. These complications can be benign, such as gingivitis caused by the difficulty of cleaning around the pillars, the need for a root canal because of the work done on the tooth; or the complications can become more serious such as a root fracture due to an excessive load. If two teeth have to be replaced, the longer bridge structure will have more complications and its longevity will decrease. Nowadays, since there are other more conservative options available, we increasingly use implants to replace missing teeth without damaging the adjacent teeth.