When is a three unit bridge better than a single tooth implant?

If the teeth on either side of the missing teeth are vital than three unit bridges have a very good chance of lasting for longer than 10 years or more  ( At least according to studies cited by Frank Spear in his presentations). If the teeth adjacent to the tooth to be extracted have crowns or large restorations and the occlusion is favorable than a three unit bridge can be an easier, faster and a less costly option.

Since three porcelain restorations are involved, color matching can often be easier as well. Also it is considerably easier plumping up a pontic site with ridge augmentation grafting procedures than adding bone vertically to an extraction site since adding gum is often easier than adding bone (at least vertically).

Single tooth implants are a very attractive alternative when the teeth on either side have root canals or are virgin ( without extensive restorations). Endodontically treated teeth may not be able to withstand the extra loading that three unit bridge abutments experience and virgin teeth are best left alone ( and not prepped to hold a bridge). In both of these instances if a patient has sufficient bone, my surgeon and I consider placing a single tooth implant instead of treatment planning a three unit bridge.

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