Dental Implants vs Bridges: Long-Term Results
The most important difference between a dental implant and a dental bridge is what happens over the years. Both can be used for many years, but the type of problems that arise, the tissues affected and the care they need are different.
In this article, drawing on systematic reviews and long-term follow-up studies, we summarise the 5, 10 and 25-year results of both treatments, the most common problems and the changes that take place in the bone after tooth loss. You can find which option suits which situation in our bridge or implant article, and the differences in daily care in our implant and bridge care article.
The Short Answer
According to systematic reviews, conventional bridges and implant-supported crowns remain in the mouth at similar rates after 10 years (around 89%). What makes the difference is the type of problem: with bridges, problems mostly arise in the abutment teeth (decay, loss of nerve vitality, fracture), whereas with implants, technical problems such as screw loosening and porcelain fracture and inflammation around the implant stand out (Pjetursson et al., 2007).
10-Year Survival: What Do the Numbers Say?
| Restoration | 5-year survival | 10-year survival |
|---|---|---|
| Conventional bridge | 93.8% | 89.2% |
| Cantilever (single-sided) bridge | – | 80.3% |
| Implant-supported single crown | 94.5% | 89.4% |
| Implant-supported bridge | 95.2% | 86.7% |
Source: Pjetursson et al., 2007. The rates show how many restorations (crowns or bridges) remained in the mouth; the survival of the implants themselves is higher.
Another systematic review calculated the 10-year survival of conventional bridges at 89.1%, but the proportion that went without any problems at all (success) was only 71.1% (Tan et al., 2004). In the review of implant-supported single crowns, the 10-year survival of the implants was 95.2% and that of the crowns on top was 89.4%; in other words, even if the implant stays in place, the crown may need to be replaced over time (Jung et al., 2012; Sailer et al., 2022).
More recent publications show that results have improved over time: in publications from after 2000, the 5-year survival of implant-supported single crowns rose from 92.6% to 97.2% (Pjetursson et al., 2014). The 5-year survival of metal-ceramic bridges has been reported as 94.4% (Pjetursson et al., 2015).
Common Problems with Bridges
The health of a bridge depends on the health of the abutment teeth that support it. According to 5-year data (Pjetursson et al., 2015):
- Decay developed at the crown margin in 1.4% of abutment teeth, and 2.1% of bridges were lost because of decay.
- Fracture was seen in 0.9% of abutment teeth.
- Bridges came loose in 3.1% of cases (loss of cementation).
- Porcelain fracture (chipping) is the most common technical problem.
Over 10 years, the reported risk was 6.4% for the bridge coming loose, 2.1% for abutment tooth fracture and 2.6% for loss of the bridge due to decay (Tan et al., 2004). The most common problems with bridges are biological ones, such as decay and loss of nerve vitality in the abutment teeth (Pjetursson et al., 2007).
Common Problems with Implants
With implant-supported single crowns, over 5 years screw loosening occurred in 8.8%, the crown coming loose in 4.1% and porcelain fracture in 3.5%; the rate of problems in the surrounding tissues was 7.1% (Jung et al., 2012). Most of these technical problems can be repaired without leading to the loss of the implant.
The main biological risk for an implant is peri-implantitis, that is, inflammation around the implant together with bone loss. A meta-analysis published in 2022 found a prevalence of peri-implantitis of 19.5% at patient level and 12.5% at implant level; the authors pointed out that definitions differed between studies (Diaz et al., 2022). With implant-supported bridges, the proportion of patients who had any problem within 5 years is higher than with conventional bridges (38.7% compared with 15.7%) (Pjetursson et al., 2007).
What Happens to the Bone After Tooth Loss?
After a tooth is extracted, the jawbone loses both width and height. Studies in humans have reported that in the first 6 months bone width decreases by 29-63% and height by 11-22% (Tan et al., 2012). In the front teeth, the loss may be more pronounced if the outer bone wall is very thin (Chappuis et al., 2013).
Although it is often said that implants preserve bone better than bridges, there is no strong study that directly compares the two treatments in this respect. Placing an implant on the same day as the extraction does not prevent the dimensional changes after extraction either (Gallucci et al., 2018). If preserving the bone is important, protective procedures carried out at the time of extraction are planned separately.
From a 25-Year Follow-Up Study
In a study that followed 40 patients for 25 years, all of whom had been treated for gum disease and attended regular maintenance, survival was 84% for tooth-supported single crowns, 63% for tooth-supported bridges, 87% for implant-supported single crowns and 64% for implant-supported bridges. The authors stressed that more than two thirds of the losses were caused by biological problems, regardless of whether the support was a tooth or an implant (Bischof et al., 2024).
This study is based on a small group of patients; even so, it is valuable because it shows that over the very long term single crowns do better than bridges, and that regular maintenance is decisive with both treatments.
What Determines the Long-Term Result?
- Oral hygiene and regular check-ups: Both decay in the abutment teeth and inflammation around implants depend largely on plaque control.
- Smoking: In smokers, the risk of implant loss is about 2.4 times higher (Mustapha et al., 2022).
- Teeth clenching: Makes porcelain fracture and screw loosening more likely; a night guard is recommended.
- Design: Single-sided (cantilever) bridges and long bridges have more problems; single crowns generally last longer.
We explain how to look after them day to day in our implant and bridge care article.
Frequently Asked Questions About the Long-Term Results of Implants and Bridges
Which one lasts longer?
In 10-year data, conventional bridges and implant-supported crowns remain in the mouth at similar rates (around 89%). Over the very long term, single crowns tend to do better than bridges.
Can the tooth under a bridge decay?
Yes. If plaque builds up at the crown margin and under the bridge, decay can develop in the abutment teeth. Regular cleaning and check-ups keep this risk low.
Can bone be lost around an implant?
If plaque control is inadequate, inflammation and bone loss (peri-implantitis) can develop around the implant. Regular professional maintenance reduces this risk considerably.
If a bridge fails, can I switch to an implant?
Yes, if your bone and general health allow it. After the old bridge is removed, an implant can be planned for the gap; bone grafting is carried out if needed.
What happens if an implant fails?
An implant that does not fuse with the bone is removed, and once the area has healed, a new implant can be placed in most cases. The cause (such as smoking, infection or bone quality) is addressed before the second attempt.
Sources
- Pjetursson BE, Brägger U, Lang NP, Zwahlen M. Comparison of survival and complication rates of tooth-supported fixed dental prostheses (FDPs) and implant-supported FDPs and single crowns (SCs). Clin Oral Implants Res. 2007;18 Suppl 3:97-113. doi:10.1111/j.1600-0501.2007.01439.x
- Tan K, Pjetursson BE, Lang NP, Chan ES. A systematic review of the survival and complication rates of fixed partial dentures (FPDs) after an observation period of at least 5 years. Clin Oral Implants Res. 2004;15(6):654-666. doi:10.1111/j.1600-0501.2004.01119.x
- Jung RE, Zembic A, Pjetursson BE, Zwahlen M, Thoma DS. Systematic review of the survival rate and the incidence of biological, technical, and aesthetic complications of single crowns on implants reported in longitudinal studies with a mean follow-up of 5 years. Clin Oral Implants Res. 2012;23 Suppl 6:2-21. doi:10.1111/j.1600-0501.2012.02547.x
- Sailer I, et al. Periodontol 2000. 2022;88(1):130-144. doi:10.1111/prd.12416
- Pjetursson BE, et al. Improvements in implant dentistry over the last decade: comparison of survival and complication rates in older and newer publications. Int J Oral Maxillofac Implants. 2014;29 Suppl:308-324. doi:10.11607/jomi.2014suppl.g5.2
- Pjetursson BE, Sailer I, Makarov NA, Zwahlen M, Thoma DS. All-ceramic or metal-ceramic tooth-supported fixed dental prostheses (FDPs)? A systematic review of the survival and complication rates. Part II: Multiple-unit FDPs. Dent Mater. 2015;31(6):624-639. doi:10.1016/j.dental.2015.02.013
- Diaz P, et al. BMC Oral Health. 2022;22:449. doi:10.1186/s12903-022-02493-8
- Tan WL, Wong TL, Wong MC, Lang NP. A systematic review of post-extractional alveolar hard and soft tissue dimensional changes in humans. Clin Oral Implants Res. 2012;23 Suppl 5:1-21. doi:10.1111/j.1600-0501.2011.02375.x
- Chappuis V, Engel O, Reyes M, et al. Ridge alterations post-extraction in the esthetic zone: a 3D analysis with CBCT. J Dent Res. 2013;92(12 Suppl):195S-201S. doi:10.1177/0022034513506713
- Gallucci GO, Hamilton A, Zhou W, Buser D, Chen S. Implant placement and loading protocols in partially edentulous patients: a systematic review. Clin Oral Implants Res. 2018;29 Suppl 16:106-134. doi:10.1111/clr.13276
- Bischof FM, et al. Clin Oral Implants Res. 2024;35:1640-1654. doi:10.1111/clr.14351
- Mustapha AD, Salame Z, Chrcanovic BR. Smoking and dental implants: a systematic review and meta-analysis. Medicina. 2022;58(1):39. doi:10.3390/medicina58010039
ORAL AND DENTAL HEALTH POLYCLINIC
TREATMENTS THAT YOU CAN RECEIVE
Implant Treatment
Porcelain Laminates
Bonding Application
Orthodontics
Ekiz Oral and Dental Health Polyclinic
We would be happy to help you achieve the smile of your dreams. You can contact us whenever you want.
+90 212 809 47 47
Working Hours: Weekdays 09:00 - 18:00, Weekends 10:00 - 16:00
[email protected]
For any questions and appointments...
Sarıyer/İstanbul
Vadikoru, No:10/A Inner Door No:100
