failure in crown and bridge

بسم الله الرحمن الرحيم

Failures in crown and bridge

Presented By
Dr. Manaf Basil

Requirement for Successful Bridgework

• Careful case selection.
• Suitable choice of abutments and retainers.
• Well executed preparation and impression.
• Good fitting temporary.
• Careful cementation of bridge.
• Regular maintenance.

Manifestations of failure

1. Pain.
2. Inability to function.
3. Inflammatory swelling.
4. Poor esthetics.
5. Broken teeth and /or restoration.
6. Bleeding gum.
7. Bad taste and/or breath.
8. anxiety.


Causes of failure
1. Faulty diagnosis and treatment plan (Improper case selection).
2. In accurate clinical or laboratory procedures.
3. Poor patient care and maintenance following insertion.

Classification of Fixed Prosthesis failures

Biological

Esthetic

Mechanical

Biological Failures

• Discomfort

Pressure on soft tissue

Traumatic occlusion
Cervical hypersensitivity

2- caries

Methods of detection.
Causes.
Management.

3- Periodontal breakdown

4- Occlusal problems

5- Pulp injury

6- Abutment fracture

Coronal
root

Mechanical Failures

• 1- Looseness or dislodgment
1- Lack of retention
.Faulty preparation
.Improper design
.Improper construction.
2- recurrent caries.
3-mobility
4-faulty cementation


• 2- Prosthesis fracture
1- joint fracture
2- facing fracture
3-all ceramic fracture( faulty preparation, faulty construction, faulty cementation).
4- post fracture.

3- Occlusal wear or perforation

Esthetic Failures

1- At the time of cementation
1- actual failure:
.Color mismatch
.Poor tooth contour, marginal roughness and extension
.Metal display in partial coverage
.Improper pontic placement
.Porcelain fracture during cementation
2- color blindness


2- Delay esthetic failures
• gingival recession
• sub pontic tissue shrinkage
• Periodontal surgery.
• Porosity
• Drifting of anterior teeth
• wear

Avoiding failures

• Caution at the planning stage.
• Confirmation of diagnosis and treatment plane for inexperienced operator.
• Expertise of the technician.
• Treatment of preoperative problems.
• Search for the primary cause of failure rather than the apparent.