Bridge

Japanese: ブリッジ（英語表記）Bridge

What is a bridge?

Bridge Bridge ( Kakogishi ) or Bridges ( Meeting ) Also called tooth decay, Periodontal disease ( Work ) For areas where teeth have been extracted for reasons such as trauma (usually 1 or 2 teeth), crowns, fillings, and other devices (abutment devices) are placed on the remaining adjacent teeth, and these are then connected to an artificial tooth (also called a pontic or dummy) in the missing area. This structure uses the remaining teeth as abutments and the artificial tooth as a bridge, restoring the form, function, and appearance of the missing area and recreating a sensation similar to that experienced before the teeth were extracted.

For a bridge to be suitable, it is important that the periodontal tissues of the remaining teeth that will support it are strong, and in some cases, treatment for periodontal disease, caries, and nerve treatment may be required as preparation for the placement of the bridge. After these treatments are completed, the bridge will be created. The type and number of remaining teeth that will support it are also important factors, and the design of the bridge will change depending on these differences.

Bridge Type

There are two types of bridges: fixed bridges, which cannot be removed, and removable bridges.

Fixed bridges are the most common type, and unlike dentures, fixed bridges are not hassle to put on and take off, so they are said to be comfortable to wear (Figure 48).

However, even if the remaining teeth are healthy, there is a disadvantage in that one layer must be removed around the teeth that will become the abutments. However, although there are limited indications, there are also adhesive bridges that attach pontics without removing the remaining teeth, so if you are reluctant to have your teeth removed, it is better to choose this method or removable dentures.

How to attach a bridge

The process of fitting a bridge involves scraping the teeth that will become the abutment, taking an impression of the teeth, creating a tooth shape on a model, and replacing them with metal or other artificial materials. In the case of bridges, dental insurance only applies to the front teeth, as the surface that comes into contact with the teeth is made of metal. In this way, the bridge, which is made up of the abutment device and artificial teeth, is attached to the teeth with dental cement (adhesive).

Bridges require careful care even after they are fitted. In particular, dirt accumulates between the abutment and the artificial teeth, so cleaning with a toothbrush and interdental brush is essential to prevent periodontal disease and tooth decay.

Akira Hamura

Figure 48 Fixed bridge
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Figure 48 Fixed bridge

Source: Houken “Sixth Edition Family Medicine Encyclopedia” Information about the Sixth Edition Family Medicine Encyclopedia

Japanese:

ブリッジとは

　ブリッジは架工義歯(かこうぎし)または橋義歯(きょうぎし)とも呼ばれます。むし歯、歯周病(ししゅうびょう)、外傷などの理由で抜歯を行った部分（通常、1～2歯）に対して、隣接する残存歯に冠、詰め物などの装置（支台装置）を設けて、欠損部の人工歯（ポンティックまたはダミーとも呼ぶ）と連結します。残存歯を橋脚とし人工歯を橋とした構造物で、欠損部の形態・機能・外観を回復し、歯を抜く前に近い感覚が再現されます。

　ブリッジが適応となるには、支えとなる残存歯の歯周組織が丈夫であることが重要であり、場合によっては、ブリッジの装着の前準備として、歯周病治療、むし歯治療、歯の神経治療などが必要になることがあります。これらの治療終了後、ブリッジ作成に入ります。また、支えとなる残存歯の種類、本数も重要な要素であり、これらの違いによってもブリッジの設計は変わってきます。

ブリッジの種類

　ブリッジの種類には、取り外し不可能な固定性ブリッジと、取り外し可能なブリッジがあります。

　通常は固定性のものが一般的で、この固定性ブリッジは義歯（入れ歯）と違い、着脱のわずらわしさがないため、装着感がよいとされています（図48）。

　しかし、残存歯が健康であっても、橋脚となる歯の周囲を1層削らなくてはならないという欠点があります。ただし適応症は限られますが、残存歯を削らずにポンティックを接着させる接着ブリッジもあるので、歯を削ることに抵抗がある場合には、この方法や取り外し式の入れ歯を選択したほうがよいでしょう。

ブリッジの装着方法

　ブリッジ装着までの行程は、支台となる歯の周囲を削ったあと、歯型をとり、模型上で歯の形をつくり、金属などの人工物に置き換えます。ブリッジの場合、歯科医療保険の適応は、歯と接する面は金属となり、歯と同色にできるのは前歯に限られます。このように、支台装置と人工歯が一体となったブリッジは歯科用セメント（接着剤）で歯に合着されます。

　ブリッジは装着後もしっかりとした手入れが必要です。とくに支台装置と人工歯の間は汚れがたまるため、歯周病やむし歯予防のために、歯ブラシ、歯間ブラシによる清掃が不可欠となります。

羽村　章

図48　固定性ブリッジ
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図48　固定性ブリッジ

出典　法研「六訂版家庭医学大全科」六訂版家庭医学大全科について　情報

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