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  • 1. BridgeFailure Dr. Aneeqa Yaqub Dr. Moazam Ali
  • 2. Manifestations of failure Pain Inability to function Dissatisfaction with esthetics Broken teeth and/or restoration Inflammatory swelling Bad taste Bad breath Bleeding gums Anxiety
  • 3. Causes of fixed prosthesis failure  Improper case selection  Faulty diagnosis and treatment plan  Inaccurate clinical or laboratory procedures  Poor patient care and maintenance following insertion
  • 4. Classification of fixed prosthesis failure Biological Esthetic Mechanical • Discomfort • At the time of • Caries cementation • Pulp injury • Delayed • Periodontal • Looseness or esthetic failure breakdown dislodgement • Occlusal • Prosthesis problems fracture • Tooth • Occlusal wear perforation or perforation • Tooth fracture
  • 5. Biological failures
  • 6. Biological Failures Occlusal problems Caries • Methods ofPeriodontal breakdown detection • Detection• Inadequate abutment • Management teeth• Periodontally affected abutment teeth• Poor oral hygiene• Improperly constructed prosthesis
  • 7. Periodontal breakdown Caries Occlusal problems
  • 8. Biological Failures Tooth perforation Discomfort• Pressure on soft tissue• Traumatic occlusion• Torque• Cervical hypersensitivity
  • 9. Discomfort Tooth perforation
  • 10. Biological Failures Abutment fracture Pulp injury • Coronal • Root • Over heating • Over reduction • Minute pulp exposure • Inadequate protection • Recurrent caries
  • 11. Pulp injury Abutment fracture
  • 12. Mechanical failures
  • 13. Mechanical Failures Occlusal wear or perforation Looseness or dislodgement • Lack of retention Prosthesis fracture o Faulty preparation o Improper design• Joint fractures o Improper• Facing fractures construction• All ceramic crown • Recurrent caries fracture • Mobility o Faulty • Torque preparation • Faulty cementation o Faulty construction o Faulty cementation• Post fracture
  • 14. Prosthesis fracture Occlusal wear Looseness
  • 15. Esthetic failures
  • 16. Esthetic Failures Delayed esthetic failures • Gingival recession At the time of cementation • Sub pontic tissue shrinkage• Actual failures • Periodontal surgery o Color mismatch • Porosity o Poor tooth contour, marginal • Drifting of anterior roughness & extension teeth o Metal display in partial • wear coverage o Improper pontic placement o Porcelain fracture during cementation• Color blindness• Unrealistic complains by the pt. o Inadequate communication o Unrealistic expectations of pt. o Dysmorphophobia
  • 17. Avoiding failures  Caution at the planning stage  Confirmation of diagnosis and treatment plan for inexperienced operator  Expertise of the technician  Treatment of preoperative problems  Search for the primary cause of failure rather than the apparent
  • 18. When the prognosis isquestionable ???The methods used to facilitate re-treatment are: Use of temporary cement Design of prosthesis for possible future addition The placement of a rest seat for possible future use Specified undercut or guide plane of a crown, even when denture is not planned Planning and noting solder joint placement Recording of shades Recording of cement used Retention of working casts and provisional restorations
  • 19. CASE Presentation
  • 20. CASE # 1•75 years old•6- units bridge Carious•Satisfactory for 9 yrs•Prefer not to have a new Abutmentsone•Clinical examination:carious abutments 11, 13Management•Caries removal•Root canal treatment•Post and core donefor each tooth•Bridge lasted for theremaining 6 years
  • 21. CASE # 2•Advanced periodontitis Periodontal•Complicated by tooth lossand mobility•Had a partial denture (notcoping well with it) Breakdown•Wishes to consider a fixedrestoration option•For health reasons implantswere not a practical optionManagement•Teeth prepared for fullcrowns•Telescopic crowns withparallel path of insertioncemented permanently• One piece fixed bridgefabricated over the crowns
  • 22. THANK YOU