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Bridge Failures
Herbert T. Shillingburg
2
Chief among the causes for bridge failures have been:
1. Faulty, and
2. Failure
3. Disregard
4. Absence
6. Faulty
of proper embrasures
5. Interproximal
inattention to treatment
spaces
Cementation failure
Mechanical failure
Caries
Necrosis of pulp
Esthetic failure
CEMENTATION FAILURE
Cement failure
Retention failure
Occlusal problems
4
Cement Failure
Cement selection
Old cement
Thin mix
Thick mix
Inadequate isolation
5
Cement Selection
ZINC PHOSPHATE
6
Thick Cement Space
Convergence below 6
Pull the crown margin and see for movement of the crown
RETENTION FAILURE
Excessive taper
Mis-fit
Mis-alignment
Retention
9
Excessive Taper
Sum of the inclination of two opposing walls give the taper of the
preparation.
10
Improving Retention
Crown lengthening
Additional abutments
11
Misfit
Causes-
No surfactant
12
Misalignment
13
Causes
Casting defects
surface of pontic.
14
Remedy
If the bridge seats fully under pressure- leave it in place for 30 min
to 1 hr asking the patient to exert gentle pressure.
Occlusal problems
Torque
Indications
15
Mobility of teeth
Tenderness on mastication
Checking occlusion
Touch
16
Distortion
Incomplete casting
Wax Patterns
Spruing stage
17
Incomplete Casting
Insufficient metal
Thin crown
Soft metal
Distortion of margins
MECHANICAL FAILURE
18
1. Retainer failure
2. Pontic failure
3. Connector failure
Retainer Failure
Perforation
Premature contacts
Soft metal
Porosity
19
Marginal Discrepancy
The more accurately the restoration is adapted to tooth, the less will
be chances of cementation failure, recurrent caries or periodontal disease.
50 to 100 discrepancy is acceptable.
20
Causes-
Selection of margin
Improper preparation
No gingival retraction
Thick cement
21
Facing Failure
Fracture
Malocclusion
Microleakage
Wearing
Deep bite
Parafunctional habits
22
Discolouration
Absorption
of
artificial
food
colouring
agents
through
the
PONTIC FAILURE
Requirements
Form & shape of gingival surface must not irritate residual ridge
Esthetics
23
Residual Ridge Contour
Ridge Contact
24
Metal Sub Structure is compromised Due to-
25
GINGIVAL AND PERIODONTAL BREAKDOWN
Supra Gingival Margins
Advantages
Easily cleanable
Disadvantages
Esthetically inferior
26
Sub Gingival Margins
Indications
Esthetic demands
Caries removal
Crown lengthening
Disadvantages
Difficult to prepare
27
CARIES
NECROSIS OF PULP
Vibration
Coolants
Desiccation
28
Chemical injury
ESTHETIC FAILURES
Requirements for Esthetic Restorations
Final impression
29
Reasons for Esthetic Failure
Improper contouring
Discoloration of facing
30
31
Shade Selection
32
REFERENCES
Shillingburg HT, Hobo S, Whitsett LD, Jacobe R, and Brackett SE:
Fundamentals of fixed prosthodontics, ed. 3, Chicago, 2001, Quintessence,
Inc.
Roberts DH: Fixed bridge prosthesis, ed. 1, Bristol, 1973, John Wright &
Sons.
Rosenstiel
SF,
Land
MF
and
Fujimoto
J:
Contemporary
fixed