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bridgefailure-120125141013-phpapp01.pdf
- 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 fixedprosthesis failure Improper case selection Faulty diagnosis and treatment plan Inaccurate clinical or laboratory procedures Poor patient care and maintenance following insertion
- 4. Classification of fixedprosthesis 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
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- 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
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- 8. Biological Failures Discomfort Tooth perforation •Pressure on soft tissue • Traumatic occlusion • Torque • Cervical hypersensitivity
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- 10. Biological Failures Pulp injury Abutmentfracture • Over heating • Over reduction • Minute pulp exposure • Inadequate protection • Recurrent caries • Coronal • Root
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- 13. Mechanical Failures Looseness ordislodgement 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
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- 16. Esthetic Failures At thetime 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 Cautionat 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 prognosisis 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
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- 21. Carious Abutments CASE # 1 •75years 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 •Advancedperiodontitis •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
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