One Missing Tooth: Implant, Bridge or Something Else, Ten Years On

By Dr. Nojan Jahedmanesh, DDS · Reviewed by Dr. Masih Rezaei, DDS · Published September 30, 2026 · Implants · 10 minute read · More articles

An implant and a bridge both look fine on the day they go in. The difference between them shows up five and ten years later, in what has needed repair, what has come loose, and what has happened to the teeth either side. Our implant or bridge page covers the five things that decide the choice at your consultation. This article takes the long view instead: what the published long-term studies say about each way of dealing with one missing tooth, including two options people often do not hear about, and what tends to go wrong with each over a decade. Pearl32 Dentistry and Wellness in Laguna Hills places implants and makes bridges in the same office, so the choice is yours to make on the evidence.

Five ways to deal with one gap

Most conversations stop at two options. There are five.

• A dental implant. A titanium fixture in the bone where the root was, a connector called an abutment, and a crown. The teeth either side are not touched. See our single dental implants page.
• A conventional bridge. The two neighboring teeth are shaped for crowns, and one piece carries a false tooth between them. Finished in weeks, with no surgery. See dental bridges.
• A resin-bonded bridge. Often called a Maryland bridge. The false tooth has a thin wing bonded to the back of one or both neighbors, with little or no drilling. It suits a front tooth with healthy neighbors and a light bite.
• A removable partial. A small plate or metal frame carrying the tooth, taken out at night. A simple acrylic one, often called a flipper, is commonly worn as a temporary while an implant heals. See dentures and partials.
• Leaving the gap. Sometimes reasonable, for a back tooth with nothing biting against it. More often it is a decision that makes itself later.

What the long-term studies say

The most reliable numbers come from systematic reviews, which pool many studies of the same treatment. They are not head-to-head trials, the patients differ, and the older studies used older materials, so read them as a picture of the pattern rather than a scoreboard.

• Implants carrying a single crown. Jung and colleagues, writing in Clinical Oral Implants Research in 2012, pooled 46 studies. The estimated survival of the implants was 97.2 percent at five years and 95.2 percent at ten. The crowns fitted to them survived at 96.3 percent at five years and 89.4 percent at ten. That gap is the practical point: the fixture usually outlasts its crown, and replacing a crown on a sound implant is a routine job.
• Conventional bridges. Tan, Pjetursson, Lang and Chan, in the same journal in 2004, pooled 19 studies. Ten-year survival was 89.1 percent, but only 71.1 percent of bridges were still free of any complication at ten years, meaning nothing had needed attention at all.
• Resin-bonded bridges. Thoma and colleagues, again in Clinical Oral Implants Research, in 2017, pooled 29 studies covering 2,300 bonded bridges. Survival was 91.4 percent at five years and 82.9 percent at ten. Bridges bonded to a single neighbor did better than those bonded to two, and front teeth did better than back teeth.

Read side by side, all three routes commonly reach ten years, and the figures for an implant carrying a single crown are the highest of the three. That is an expectation built on averages, not a promise for your mouth. No dentist can promise a lifespan, and all treatment carries risks, which we go through with you before you consent to anything.

What tends to go wrong with each

The implant. The things that need attention over the years are mostly small and mechanical. In the Jung review, the screw holding the crown had loosened in 8.8 percent of cases by five years, and the gum around the implant had become inflamed or receded in 7.1 percent. Bone loss of more than 2 millimeters around the fixture was seen in 5.2 percent. That last one matters most, because inflammation around an implant, left alone, can progress the way gum disease does around a tooth. Daily cleaning and regular checks keep it small. Our failing implants page covers what happens when it is not caught.

The bridge. A bridge usually fails at one of the two teeth holding it, not in the porcelain. In the Tan review, 6.4 percent of bridges came loose over ten years. Decay under a crown ended 2.6 percent, and a fractured supporting tooth ended 2.1 percent. The weak points are the margin where each crown meets its tooth, and the gum under the false tooth, which ordinary floss cannot reach without a threader or a water flosser. When one supporting tooth fails, the whole bridge usually comes off with it, and the next plan has a wider gap to fill.

The bonded bridge. Its common problem is coming unstuck. In the Thoma review, 15 percent had debonded at least once within five years. It can often be bonded back, which is why it remains a good choice for the right front tooth, but a heavy bite or a grinding habit works against it.

The partial. A removable partial is the least invasive option and the least stable. Its clasps rest on the neighboring teeth and can loosen them over time, food collects under the plate, and it comes out at night. Many people find a one-tooth partial fine as a stopgap and tiresome as a permanent answer.

The empty gap. Leaving a gap is not neutral. Craddock and Youngson measured this in the British Dental Journal in 2004. Of the teeth that had lost the tooth they bit against, 83 percent had over-erupted, growing into the space by as much as 5.4 millimeters. About half of those had begun to interfere with the bite. The neighbors tend to tip into the gap as well. And the bone at the empty site shrinks fastest in the first year, which can turn an easy implant later into one that needs a graft first.

Front tooth or back tooth

Where the gap is changes the weighting. At the front, appearance leads. An implant crown at the front needs enough bone and gum to look natural at the gumline, and a temporary tooth covers the space while it heals. A bonded bridge is often a good fit for a single front tooth with untouched neighbors.

At the back, chewing load leads. Molars take the most force, which is hard on bonded bridges and on the supporting teeth of a long bridge, and it is where an implant’s independence from its neighbors pays off. A back tooth with nothing biting against it is the one gap we sometimes suggest leaving, after checking that nothing is drifting.

Counting the cost over years, not visits

A bridge usually costs less than an implant at the start. Over twenty years the totals often come closer. A bridge may be remade once, and its supporting teeth may need root canals or new crowns along the way. An implant crown may be replaced once, on a fixture that stays. Dental plans treat each option differently, so we check yours before you decide.

You get an itemized written estimate for each option side by side, with any graft, extraction or temporary tooth on its own line. Our insurance page lists the plans we accept, and our financing page covers the third party options, none of which are through the practice itself.

How we help you choose

It starts with a 3D cone beam scan, so the bone is measured rather than guessed; our CBCT page explains it. We look at the two neighboring teeth with you on the screen, because their condition decides more cases than anything else. Implant placement, any grafting and the crown are done in this office, and bridge crowns are designed and milled here on the same equipment as our same-day crowns. How implants fit the wider picture is on our implant dentistry page.

Dr. Nojan Jahedmanesh holds a certificate in prosthodontics from UCLA and practices as a general dentist. Pearl32 Dentistry and Wellness has been serving the Laguna Hills community since 1994.

Questions people ask

How long does an implant last compared with a bridge?

No dentist can promise a lifespan. In the long-term reviews, 95.2 percent of implants carrying a single crown were still in place at ten years, with the crowns on them at 89.4 percent, while conventional bridges survived at 89.1 percent over the same period. An implant crown can be replaced on the same fixture; when a bridge fails, it usually comes off with one of its supporting teeth.

What is a Maryland bridge?

A resin-bonded bridge: a false tooth with a thin wing bonded to the back of one or both neighboring teeth, with little or no drilling. It suits a single front tooth with healthy neighbors and a light bite. In a 2017 review of 2,300 of them, 82.9 percent survived ten years, and 15 percent came unstuck at least once within five years, which can often be bonded back.

Can I just wear a flipper?

As a stopgap, yes. A flipper is a small removable plate carrying one tooth, and it is often worn to cover a gap while an implant heals. As a permanent answer most people find it tiresome: it comes out at night, food collects under it, and its clasps can loosen the teeth they rest on over time.

Is it all right to leave a missing back tooth?

Sometimes. A back molar with nothing biting against it can occasionally be left, if the neighbors are not drifting. More often the gap changes things: in one study, 83 percent of teeth that had lost their opposing tooth had grown into the space. The bone at the site also shrinks, fastest in the first year, which can mean a later implant needs a graft first.

This article is general information, not a diagnosis. What is right for you can only be decided after an examination.