Guide · Full-arch
Broken tooth on a full-arch bridge: what to send the lab
What to record before taking out the bridge, why acrylic teeth break (bruxism, opposing arch, wear) and what to send the lab for a tooth replacement.
Short answer
A tooth replacement on a full-arch bridge swaps out a fractured acrylic tooth without remaking the prosthesis. Before removing the bridge, scan the arch with it in place, plus the opposing arch and bite; then check the screws and the framework. Send the cleaned, disinfected bridge, the FDI tooth number, the shade and the prescription.
Step by step
- 01
Record the tooth and the bite with the bridge in place
Photograph the fractured tooth and scan the arch with the bridge seated, the full opposing arch and a bite on both sides. With the bridge in the mouth, the bite holds the vertical dimension the new tooth has to match.
- 02
Mark the contacts before removing it
Mark centric and excursive contacts. A contact concentrated on the broken tooth or on the cantilever goes on the order, because it changes what the repair should include.
- 03
Remove the bridge and check screws and framework
With the bridge out, check for loose or fractured screws and for cracks in the bar or the acrylic base. A cracked framework isn't fixed with a tooth replacement: talk to the lab before you ship it.
- 04
Look for the cause
Ask about clenching and grinding, look for wear facets on the other teeth and note the opposing dentition. Natural teeth or a fixed prosthesis on the other arch raise the risk of another fracture.
- 05
Clean, disinfect and fill in the order
Clean and disinfect the bridge. On the order, list the teeth to replace by FDI number, the shade from the guide, what happened (fracture, chipping, debonding or wear) and whether it's the first time.
- 06
Plan prevention
With bruxism or a repeat fracture, discuss an occlusal guard with the patient after the repair. If wear is generalized, discuss the material for the next bridge as well.
Why do acrylic teeth on a full-arch bridge break?
Acrylic teeth on a full-arch bridge break from fatigue and overload, and the odds rise with time in service. Papaspyridakos and colleagues pooled 281 full-arch bridges with a mean exposure of 9.5 years in a systematic review (The International Journal of Oral & Maxillofacial Implants, 2012). Chipping or fracture of the veneering material was the most common prosthesis-related technical complication: 33.3% at five years and 66.6% at ten.
Bruxism is the strongest factor in the data. Chrcanovic, Kisch and Larsson (Clinical Oral Implants Research, 2020) followed 869 full-arch bridges for 10.7 years on average. Bruxism doubled the risk of losing or fracturing an acrylic tooth (HR 2.1), and that risk was also higher in men, in the maxilla, and when the opposing arch had natural teeth or a fixed prosthesis.
In a smaller series of 24 patients followed for 4 to 10 years (Acar and Koçak-Büyükdere, BMC Oral Health, 2026), probable bruxism went with more chipping. The authors call for larger samples to confirm it.
Fracture, wear or debonding: what does the sign tell you?
The kind of damage points to the likely cause and to what’s needed beyond a new tooth. The associations below come from retrospective studies; use them to guide the workup, not to close the diagnosis.
| cause | sign | what to do | source |
|---|---|---|---|
| Bruxism | fractured or loose tooth, wear facets, loose screw | confirm on history and exam; occlusal guard after the repair | Chrcanovic and colleagues, 2020; Papaspyridakos and colleagues, 2020 |
| Opposing natural teeth or fixed prosthesis | fracture that recurs in the same segment | adjust contacts and discuss the material for the next bridge | Chrcanovic and colleagues, 2020 |
| Acrylic wear over time | flattened posterior teeth, lost contact | replace the worn teeth and review the occlusion | Papaspyridakos and colleagues, 2020; Purcell and colleagues, 2008 |
| Fatigue over the years | chipping after years without trouble | repair and periodic review of the bridge | Papaspyridakos and colleagues, 2012 |
Wear hits acrylic harder. In Papaspyridakos and colleagues (Journal of Prosthodontics, 2020), covering 71 full-arch bridges, the annual rate of material wear was 19.4% for metal-acrylic and 7.3% for porcelain. In the series by Purcell and colleagues (2008), posterior tooth replacement was 52.5 times more likely after five years in service than in the first two.
What should you check before sending the bridge?
Before sending the bridge, make sure the tooth is the only problem. The bruxism that breaks teeth also loosens and fractures screws: in Chrcanovic’s study, the risk of screw loosening was higher in patients with bruxism (HR 3.3), and so was the risk of screw fracture (HR 5.0).
A crack in the bar or a fracture of the acrylic base changes the job. In that case, send photos to the lab before you remove the bridge and agree on the route; a tooth replacement won’t fix it.
What do you send the lab for a tooth replacement?
For a tooth replacement, the lab needs the bridge cleaned and disinfected, the teeth to replace by FDI number, the shade, the opposing arch with the bite, and a signed prescription. The full list is on our repairs and relines page.
Also note what happened, whether it’s the first time and what you saw on the contacts. The material of the replacement tooth is confirmed when the case is opened. If the patient can’t go without the bridge, say so on the order; a rush fee is available. In our dentist portal (its screens are in Portuguese), the order shows the turnaround in business days before you submit it.
When isn’t a new tooth enough?
A new tooth isn’t enough when fractures keep recurring in the same segment, when wear is generalized or when the framework is compromised. In Papaspyridakos and colleagues (2020), bruxism and not wearing a night guard went with more chipping of the prosthetic material.
With bruxism, our milled PMMA occlusal splint is an option after the repair, and the indication is yours. If the plan is to change materials, our article on full-arch zirconia, titanium or PMMA compares the options.
What if the bridge is zirconia?
The tooth replacement described here is for acrylic full-arch bridges. In monolithic zirconia, the teeth are part of the same piece, so chipping or fracture is assessed case by case: send photos to the lab before removing the bridge. Our full-arch zirconia bridge page covers what the studies show on chipping and restorative space.
Who does tooth replacements at Smile Digital Lab?
Smile Digital Lab, a digital dental lab in São Paulo, Brazil, making restorations for oral rehabilitation, replaces full-arch bridge teeth in its own resin department. We check every case when it arrives and on eight points before it ships, and you follow the repair’s stage in the portal.
Related services
Open a portal accountFrequently asked questions
Why send a bite record if the bridge is going to the lab?
Because the new tooth has to meet the opposing arch at the same vertical dimension as the others. Scanned with the bridge in the mouth, before removal, the bite keeps that relationship; without it, the new tooth's contact is rebuilt with no reference.
Can a broken tooth be a sign of overload on the implants?
It can point to the same overload. In the study by Chrcanovic and colleagues (2020), covering 869 full-arch bridges, implants in patients with bruxism had lower survival, and prosthesis failure was more likely in that group (HR 3.3). At the repair visit, check the screws and bone levels.
Can you replace just the broken tooth and keep the rest?
Yes. In a tooth replacement, the framework and the other teeth stay; only the fractured, chipped, worn or debonded tooth comes out. When several teeth are worn at once, it's worth asking whether the problem is still local.
Sources
- A systematic review of biologic and technical complications with fixed implant rehabilitations for edentulous patients · The International Journal of Oral & Maxillofacial Implants (Papaspyridakos et al., 2012)
- Retrospective evaluation of implant-supported full-arch fixed dental prostheses after a mean follow-up of 10 years · Clinical Oral Implants Research (Chrcanovic, Kisch and Larsson, 2020)
- Technical complications and prosthesis survival rates with implant-supported fixed complete dental prostheses: a retrospective study with 1- to 12-year follow-up · Journal of Prosthodontics (Papaspyridakos et al., 2020)
- Prosthetic complications in mandibular metal-resin implant-fixed complete dental prostheses: a 5- to 9-year analysis · The International Journal of Oral & Maxillofacial Implants (Purcell et al., 2008)
- Long-term outcomes and complications of full-arch implant-supported fixed prostheses: a 4-10 year retrospective study · BMC Oral Health (Acar and Koçak-Büyükdere, 2026)
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