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Failures in FPD

The document discusses factors that can cause failure of crowns and bridges. It classifies failures according to when they occur: during cementation, as biological failures over time, or as mechanical failures. Biological failures include issues like pain, sensitivity, caries, and periodontal disease. Mechanical failures involve problems with the cement, restoration materials, or occlusion. Maintaining good oral hygiene is important to avoid failures after treatment.

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Eazhil Raj
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166 views57 pages

Failures in FPD

The document discusses factors that can cause failure of crowns and bridges. It classifies failures according to when they occur: during cementation, as biological failures over time, or as mechanical failures. Biological failures include issues like pain, sensitivity, caries, and periodontal disease. Mechanical failures involve problems with the cement, restoration materials, or occlusion. Maintaining good oral hygiene is important to avoid failures after treatment.

Uploaded by

Eazhil Raj
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Failure of Crowns and

Fixed Dental Prosthesis

Dr. Hesham I. Othman,


Prof. and Head of Crown and Bridge Dept. Al-Azhar Univ.
FACTORS CAUSING FAILURE OF CROWNS AND BRIDGES
COULD BE CLASSIFIED ACCORDING TO THE STAGE IN
WHICH IT OCCURS AS FOLLOWS:

CEMENTATION
Classification according to mechanism of
failure
Biologic
Failure

Failure of Mechanical
Maintenance fixed
Failure Failure
prosthesis

Esthetic
Failure
Patient complaint may be;

1- Immediate
2- Delayed
Biological Failure
1.
2.
3.
4.
5.
6.
7.
Discomfort, Pain and Sensitivity
Excessive Retention of food Traumatic Torque Cervical
Pressure on soft on the occlusal occlusion hypersensitivity of
tissues surface the abutment
Improper pontic/ Lack of auxiliary Premature contact Lack of parallism Over displacement
ridge relationship escape grooves between abutments of gingival tissue
during impression
taking
Foreign body Improper buccal Absence of Over extended
pressing on the and lingual --- temporary temporary
ridge embrasures protection protection
Over extension Over extended
cervical margins of --- --- --- cervical margins of
retainers or crowns restoration
Faulty proximal --- --- --- Short or open
contact cervical margins of
restoration
Improper labial or Cervical caries
lingual contour of --- --- ---
retainers or pontics
CARIES
1.
2.
3.
4.
5.

6.
PULP INJURY
due to;
1. Improper use of coolant.
2. Over reduction leaving insufficient dentin protective
barrier.
3. Minute pulp exposure.
4. Improper or absence of temporary protection.
5. Use of irritating luting agent.
6. Recurrent caries under the restoration
7. Low grade pulp irritation as a results of traumatic
occlusion
PERIODONTAL BREAKDOWN
periodontal breakdown may lead to loss of abutment

Patient suffer from;


- Mobility of abutment
- Periodontal pocket formation
- Periodontal abscess
- Pain which prevent mastication at the side of restoration
- Bad odor and taste
Periodontal breakdown may be due to;

1. Inadequate abutment teeth in long span bridge.


2. Periodontally affected abutment teeth.
3. Patient with poor oral hygiene.
4. Poor marginal adaptation.
5. Over or under contour of axial walls
6. Extensively large connectors that restrict the cervical
embrasure.
7. Pontic with large contact area on edentulous ridge.
8. Improper or absence of proximal contact causing
food impaction and periodontal pocket formation.
9. Irregular or rough cervical margin of prosthesis.
OCCLUSAL PROBLEMS
Premature contact in centric and eccentric occlusion

excessive tooth mobility.


TOOTH PERFORATION
due to;
- Faulty preparation during pinhole preparation.

- Faulty during post space preparation.


TOOTH FRACTURE
1- Coronal tooth fracture

Due to;
1. Over reduction of abutment
2. Recurrent caries
3. Un-retained restoration
4. Presence of premature contact or heavy occlusal
force
5. Application of excessive force during seating of
improperly fitting restoration
6. Incorrect removal of cemented restoration
2- Root fracture

Due to;

1. Excessive widening of root canal during endodontic


treatment or during post space preparation
2. Forceful seating of post
3. Caries extended to root surface
4. Trauma
MECHANICAL FAILURE
1. Cementation failure; looseness and/or dislodgment of
restoration, it could be due to
a- Cement failure
b- Retention failure
c- Occlusal problems
d- Different degree of abutments mobility
2. Restoration failure ( retainer, pontic, or connector )
3. Occlusal wear or perforation
1- Cementation Failure
a- Cement failure
This could be due to;
1- Cement selection
2- Expired cement
3- Clinician not follow manufacturer’s instructions
4- Incomplete removal of temporary cement
5- Inadequate isolation
6- Inclusion of cotton fibers
7- Incomplete isolation
8- Insufficient pressure seating
1- Cementation Failure
b- Retention failure
This could be due to;

1- Excessive taper
2- Short clinical crown
3- Misfit
4- Misalignment
1- Cementation Failure
c- Occlusal problems

This could be due to;

1- occlusal interference
2- Occlusal perforation
3- Parafunctional activity
4- Loss of occlusal contacts
1- Cementation Failure
d- Different degree of abutments mobility

This induce stresses on the cement which lead to


cementation failure
How to confirm cementation failure?

1- Pull the restoration margin and


see for movement of it.

2- Bubbles come out of the margin


or perforation (if present) when the
restoration pushed by occlusal
pressure
2- Restoration Failure

a- Retainer failure;

- Perforation

- Marginal discrepancy

- Veneering separation, fracture or wearing


b- Pontic failure;
- Pontic fracture (Porcelain) with unfavorable occlusal
load

- Limited occlusocervical height due to over eruption


c- Connector failure;
This could be due to;

1- Improper designing of connector size and position

2- Thin metal at the connector

3- Incorrect selection of solder

4- Porosity
Occlusal wear or perforation

Heavy chewing, clenching or Bruxism

wear of restoration

perforation of occlusal surface of


the metal restoration

Leakage, cement dissolution & caries


Esthetic Failure
► Improper shade matching
► Insufficient tooth reduction
► Disharmony between restoration and neighboring
teeth
► Improper masking of metal by esthetic material
► Use of improper shade of cement with all ceramic
restoration
► Unnecessary display of metal in case of partial
veneer metal restoration
► Improper marginal adaptation, form, roughness, or
extension which lead to gingival inflammation
causing unnatural soft tissue color
Maintenance Failure
Poor oral hygiene and improper maintenance of a well
done restoration may lead to failure of prosthesis.

The patient must be fully informed about his responsibility


in success or failure of restoration

The dentist must recall the patient for periodic clinical and
radiographic examination to detect early any harmful
changes that might occur.

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