Bridge failure

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Bridge failure

  1. 1. BridgeFailure Dr. Aneeqa Yaqub Dr. Moazam Ali
  2. 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. 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. 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. 5. Biological failures
  6. 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. 7. Periodontal breakdown Caries Occlusal problems
  8. 8. Biological Failures Tooth perforation Discomfort• Pressure on soft tissue• Traumatic occlusion• Torque• Cervical hypersensitivity
  9. 9. Discomfort Tooth perforation
  10. 10. Biological Failures Abutment fracture Pulp injury • Coronal • Root • Over heating • Over reduction • Minute pulp exposure • Inadequate protection • Recurrent caries
  11. 11. Pulp injury Abutment fracture
  12. 12. Mechanical failures
  13. 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. 14. Prosthesis fracture Occlusal wear Looseness
  15. 15. Esthetic failures
  16. 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. 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. 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. 19. CASE Presentation
  20. 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. 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. 22. THANK YOU

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