This document discusses bridge failures in dentistry. It identifies the main manifestations of failure as pain, inability to function, dissatisfaction with aesthetics, and other issues. Failures are classified as biological, mechanical, or esthetic. Biological failures include issues like caries, periodontal breakdown, pulp injury, and tooth perforation. Mechanical failures involve looseness, fracture of the prosthesis, and occlusal wear. Esthetic failures occur at cementation or later due to issues like gingival recession or color mismatch. The document provides examples and descriptions of various types of failures and recommends avoiding failures by careful planning, addressing preoperative problems, and designing prostheses to allow for future treatment if needed. It also presents two

1. Bridge
Failure
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 of
Periodontal 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

18. 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

19. When the prognosis is
questionable ???
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

20. CASE Presentation

21. CASE # 1
•75 years old
•6- units bridge
Carious
•Satisfactory for 9 yrs
•Prefer not to have a new
Abutments
one
•Clinical examination:
carious abutments 11, 13
Management
•Caries removal
•Root canal treatment
•Post and core done
for each tooth
•Bridge lasted for the
remaining 6 years

23. CASE # 2
•Advanced periodontitis
Periodontal
•Complicated by tooth loss
and mobility
•Had a partial denture (not
coping well with it) Breakdown
•Wishes to consider a fixed
restoration option
•For health reasons implants
were not a practical option
Management
•Teeth prepared for full
crowns
•Telescopic crowns with
parallel path of insertion
cemented permanently
• One piece fixed bridge
fabricated over the crowns

25. THANK YOU