Three or four missing teeth side by side do not usually need three or four implants. Two implants, one at each end of the gap, can often carry a fixed bridge that fills the whole space, with the middle teeth resting over the gum between them. That is an implant-supported bridge, and for longer gaps it is one of the most common fixed options.
The bridge is screwed or cemented to the implants, so it stays in the mouth and is cleaned in place. It does not lean on your natural teeth for support.
Fewer implants than teeth, by design
Each implant is a post, usually made of titanium, that sits in the jawbone and, over a few months of healing, becomes firmly anchored to it. Our guide to how implants bond to bone explains that process. Once the implants are stable, they can carry a joined row of teeth. The teeth that sit over the gum without an implant under them are called pontics.
How many implants are needed depends on the length of the gap, where it is in the mouth, how much bone there is, and how hard you bite. A short gap of three teeth may be bridged by two implants. A longer gap, or one at the back of the mouth where chewing forces are higher, may need more. The number is worked out from a 3D scan rather than a fixed formula.
Your neighbouring teeth are left alone
The main difference from a traditional bridge is what holds it up. A traditional bridge is fixed to crowns on the natural teeth either side of the gap, so those teeth have to be shaped down to take the crowns. If they are healthy and unfilled, that means removing sound tooth structure. An implant-supported bridge rests only on the implants, so the neighbours can be left as they are.
A removable partial denture is the third common choice. It clips onto remaining teeth and comes out for cleaning. It usually costs the least at the start and needs no surgery, but many people find it less stable for chewing.
| Implant-supported bridge | Traditional bridge | Partial denture | |
|---|---|---|---|
| What holds it | Two or more implants | Crowns on the teeth either side | Clasps and the gum |
| Surgery needed | Yes | No | No |
| Neighbouring teeth shaped | No | Yes | Sometimes minor changes |
| Fixed or removable | Fixed | Fixed | Removable |
Our article comparing implants, bridges and dentures goes through each option in more depth.
How implant bridges hold up over time
A 2012 review in Clinical Oral Implants Research (Pjetursson and colleagues) pooled 32 studies of implant-supported bridges. The implants themselves had an estimated survival of 95.6% at five years and 93.1% at ten. For bridges with a metal-ceramic construction, 96.4% were still in place at five years and 93.9% at ten.
The same review was frank about maintenance. Only about two thirds of patients had no complication of any kind over five years. Among the most common problems were chipping or fracture of the porcelain (13.5%), gum inflammation or infection around the implants (8.5%), and loose screws or abutments (5.3%). Most of these can be repaired, but it shows why regular reviews matter.
Bone, gums and health decide whether it suits you
The implants need enough healthy bone to sit in. After teeth are lost, the ridge of bone often shrinks, especially in the first months, as our article on bone loss after an extraction explains. Where there is not enough, a bone graft may be needed first, or the implants may be placed in a different position.
Gum disease should be treated and under control before implants go in, because the same bacteria can affect the gum and bone around implants. Smoking and poorly controlled diabetes raise the risk of problems with healing and with the implants over time, so they are discussed during planning.
Implants carry chewing force into the bone, which helps keep the bone around them in use. The bone under the pontics is not supported in the same way and may still slowly shrink, so a bridge is designed with that in mind.
From scan to final bridge
- Assessment and planning, including an X-ray and 3D scan to measure the bone and plan where the implants go.
- Placing the implants, usually under local anaesthetic. Any grafting may happen at the same visit or earlier.
- Healing, usually a few months, while the implants anchor to the bone. A temporary tooth replacement can often be worn during this time.
- Scanning the healed implants and making the bridge.
- Fitting the bridge and checking the bite, then regular reviews.
The timeline varies with grafting, the site and how the bone heals, which is why every plan is individual.
Cleaning under the bridge
Plaque collects where the bridge meets the gum, and especially under the pontics. Interdental brushes, floss designed to thread under bridges and a water flosser can all help reach those areas. Your dentist or OHT can show you which tools fit your bridge. Our guide to cleaning dental implants has more detail.
Cost
The price of an implant-supported bridge depends on the number of implants, the number of teeth in the bridge, the material and any grafting. As typical Australian market figures, a single implant with a crown usually costs $4,000 to $7,000, and a three-unit traditional bridge $3,500 to $6,500. An implant bridge for a longer gap is usually more than a traditional bridge, though it can cost less than placing an implant for every missing tooth. These are general ranges, not Lumi fees, and a quote after a scan is the only way to know your own figure.
Common questions
Is an implant bridge stronger than single implants?
Not necessarily stronger, but it uses fewer implants. Single implants for every tooth can be easier to clean between, and if one has a problem the others are not affected. Which suits you depends on the gap and the bone.
What if I am missing all my teeth in one jaw?
Then a full-arch bridge on several implants is usually the comparison to make. See full-arch implants at Lumi and our full-arch implant cost guide.
Can the bridge be removed for repairs?
A screw-retained bridge can be unscrewed by the dentist for cleaning or repair, which is one reason many implant bridges are made that way.
If you are missing several teeth in a row and want to know whether an implant bridge fits your situation, our dentists can assess your bone with a 3D scan at our Melrose Park practice. Read about our dental implant options, see our free implant consult on current offers, or contact us.
