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Jogeswar Barman
FAILURES IN FIXED PARTIAL DENTURES
CLASSIFICATION
Bennard G. N. Smith
1. Loss of retention
2. Mechanical failure of crowns or bridge components
a. Porcelain fracture
b. Failure of solder joints
c. Distortion
d. Occlusal wear and perforation
e. Lost facings
3. Changes in the abutment tooth
a. Periodontal disease
b. Problems with the pulp
c. Caries
d. Fracture of the prepared natural crown or root
e. Movement of the tooth
4. Design failures
a. Under-prescribed FPDs
b. Over-prescribed FPDs
5. Inadequate clinical or laboratory technique
a. Positive ledge
b. Negative ledge
c. Defect
d. Poor shape and color
6. Occlusal problems
I. Cementation failure
II. Mechanical failure
III. Gingival and periodontal breakdown
IV. Caries
V. Necrosis of pulp
VI. Biomechanical failure
VII. Esthetic failure
I. CEMENTATION FAILURE Can be broadly divided into:
1. Cement failure
2. Retention failure
3. Occlusal problems
4. Distortion of FPD
2. retention failure
For a restoration to accomplish its purpose, it must stay in
place on the tooth. The geometric configuration of the tooth preparation
must place the cement in compression to provide the necessary
retention and resistance.
Clinical conditions with excessive taper and short clinical crowns should
be treated with:-
Misfit : The fit of casting can be defined best in terms of the “misfit”
measured at various points between the casting surface and the tooth.
Misalignment :
it is more difficult to differentiate whether a FPD is not seating because
of a faulty fit, or the alignment of the retainers relative to each other is
incorrect.
The only difference which may sometimes be apparent is that, in the
case of misalignment the FPD will have some ‘spring’ in it and tend to
seat further on pressure due to the abutment teeth moving slightly,
whereas in the case of a defective fit, the resistance felt will be solid.
3. occlusal problems
Following the placement of a dental restoration, a patient might
report discomfort ranging from a feeling of ‘lameness’ to ‘severe and
constant pain’. Sensitivity, in most cases, is due to pulp irritation from
traumatic contact or greater leverages. When the occlusion has been
adjusted, each type of discomfort may be relieved almost instantly and
should disappear shortly.
4. Distortion of Fpd
Causes of distortion:
¾ Casting defects- distorted margin, rough castings, banding of the
FPD due to improper care taken during wax pattern making,
investing and casting procedures.
¾ Bending of long span FPDs due to Thin crown, Soft metal, Heat
treatment not being done, Porosity in the metal
¾ Distortion of the metal substructure during the porcelain firing
Contaminated metal
II MECHANICAL FAILURES
Classification of mechanical failure
1. Retainer failure
2. Pontic failure
3. Connector failure
1. RETAINER FAILURE
1) Perforation
2) Marginal discrepancy
3) Facing failure
Fracture
Wearing
Discoloration
1) Perforation
Causes
a) Insufficient occlusal reduction
b) Insufficient occlusal material
c) High points in opposing dentition (plunger cusp)
d) Premature contacts
e) Contaminated metal
f) Porosity in metal work (subsurface, back pressure, suck
back)
g) Due to improper melting temperature
h) Improper pattern position
i) Improper sprue (too thin)
j) Improper location
k) Parafunctional habits
2) Marginal discrepancy
Causes
a) Selection of margin
b) Improper preparation and failure to establish the margin properly
c) Failure to do gingival retraction prevents definite margin location and
subsequently in impression
d) Selection of the impression material
i. Shrinkage in material (condensation silicon)
ii. Distortion of material (alginate)
e) Improper impression procedures
f) Voids in the impression
g) Variation in pressure application in wash technique
h) Delayed pouring of die material
i) Distortion of wax patterns at margins
j) Insufficient flow of metal
k) Shrinkage of metal
l) Nodules in margins and inner side of coping
i. Due to inadequate vacuum during investing
ii. Improper brushing technique
iii. No surfactant
m) Excessive sand blasting
n) Distortion due to degassing procedure
o) Open margins due to porcelain shrinkage (opaque porcelain)
p) Thick mixing of luting agent
q) Cement setting prior to seating
r) Insufficient pressure application during cementation
3. Facing failure
2. PONTIC FAILURE
3. CONNECTOR FAILURE
The connector is that part of the FPD or splint that joins the
individual components (retainers and pontics) together.
Causes for connector failure
Improper selection of connector
Thin metal at the connector
Incorrect selection of solder
Solder gap – narrow or wide
Porosity
Insufficient metal around
Defective occlusal contacts over thin connectors
Each step in full crown preparation presents hazards, which may injure
the pulp. In general, heat desiccation and / or chemical injury cause the
insult.
The result may be pulpitis or even necrosis. Among the many essential
procedures that may cause pulp injury are:
Tooth preparation: excessive heat generation, over preparation with
less than 1mm of reaming dentin
Impression making: irritation from the impression materials
Pulp infection: from microbial infiltration due to poor oral health and
faulty temporization and cementation.
VI BIOMECHANICAL FAILURE
Causes:
Failure in selection of right abutment
Lack of retention and resistance form
Incorrect design of FPD
Wrong material selection