failure

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
• Discomfort
• Caries
• Pulp injury
• Periodontal
breakdown
• Occlusal
problems
• Tooth
perforation
• Tooth fracture
Biological
Mechanical
• Looseness or
dislodgement
• Prosthesis
fracture
• Occlusal wear
or perforation
Esthetic
• At the time of
cementation
• Delayed
esthetic failure

5. Biological failures

6. Biological Failures
Periodontal breakdown
Caries
• Inadequate abutment
teeth
• Periodontally affected
abutment teeth
• Poor oral hygiene
• Improperly constructed
prosthesis
• Methods of
detection
• Detection
• Management
Occlusal problems

7. Periodontal breakdown
Caries
Occlusal problems

8. Biological Failures
Discomfort
Tooth perforation
• Pressure on soft tissue
• Traumatic occlusion
• Torque
• Cervical hypersensitivity

9. Discomfort
Tooth perforation

10. Biological Failures
Pulp injury
Abutment fracture
• Over heating
• Over reduction
• Minute pulp
exposure
• Inadequate
protection
• Recurrent caries
• Coronal
• Root

11. Abutment fracture
Pulp injury

12. Mechanical failures

13. Mechanical Failures
Looseness or dislodgement
Prosthesis fracture
Occlusal wear or perforation
• Lack of retention
o Faulty preparation
o Improper design
o Improper
construction
• Recurrent caries
• Mobility
• Torque
• Faulty cementation
• Joint fractures
• Facing fractures
• All ceramic crown
fracture
o Faulty
preparation
o Faulty
construction
o Faulty
cementation
• Post fracture

14. Occlusal wear
Prosthesis fracture
Looseness

15. Esthetic failures

16. Esthetic Failures
At the time of cementation
Delayed esthetic failures
• Actual failures
o Color mismatch
o Poor tooth contour, marginal
roughness & extension
o Metal display in partial
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
• Gingival recession
• Sub pontic tissue
shrinkage
• Periodontal surgery
• Porosity
• Drifting of anterior
teeth
• wear

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. Carious
Abutments
CASE # 1
•75 years old
•6- units bridge
•Satisfactory for 9 yrs
•Prefer not to have a new
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. Periodontal
Breakdown
CASE # 2
•Advanced periodontitis
•Complicated by tooth loss
and mobility
•Had a partial denture (not
coping well with it)
•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