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RESEARCH

Failures of crown and fixed partial dentures - A clinical


survey
Sudhir Pawar
ABSTRACT

reporting at our Institute by collecting the data after


proper clinical examination and diagnosis.

Failure of restorations is an important concern in dentistry. A


clinical survey was conducted to assess the various failures
associated with crowns and fixed partial dentures. The number of

Method and Materials

units involved and the type of materials used in fabrication of


prosthesis were taken into consideration and the frequency of
failures was analyzed. Out of 87 cases surveyed, 68 crowns and
19 fixed partial dentures demonstrated failure. The most
common cause of failure in crown and fixed partial dentures was
due to the lack of retention.

Keywords: Crowns, fixed partial dentures, failure.

Introduction

A sample questionnaire was prepared in order to collect


the relevant data. The questions pertained to the
period of the prosthesis in place, the nature of
complaint as told by patient in his or her own words,
number of units involved, and the type of materials
used in fabrication of prosthesis.

Results

Total number of failures of crowns and fixed partial


dentures were 87.The number of failures in Crowns was
Demand to replace the lost or missing teeth by means
68 while the number of failures in case of fixed partial
of fixed partial denture has been ever increasing. Since
dentures was 19.
a fixed prosthesis assures the greater retention and
stability in addition to comfort, it is more or less
The types of failures3 were categorized, tabulated and
considered as the next best to replace the lost tooth or
1
their frequency was found out represented in Table 1.
teeth and thereby restore their functions. Even if this
modality of treatment has one distinct disadvantage of
requiring a natural tooth structure to be sacrificed, in
Discussion
order to prepare the tooth or teeth for receiving the
retainers or a restoration as the case may be. Given the
The most common cause of failure in crown and fixed
other modality of having a fixed prosthesis by means of
partial dentures was the lack of retention amounting to
taking support from implant is picking up, the same may
45 %, which can be attributed to various causes like
not be in the reach of many for reasons like financial
improper preparation of tooth with too much taper of
affordability, lack of available facilities in nearby
proximal walls, one of the proximal walls being too
surroundings, as well as non willingness to undergo
short, and lack of resistance form.4,5 It can also be
surgical procedures and so on. Implant supported
attributed to improper cementation and lack of
crown or fixed partial denture has a distinct advantage
adjustment of occlusion during eccentric mandibular
of sparing the natural tooth structure from that of
movements6.
abutment teeth as required in conventional crown or
2
The most common cause of pain under the restorations
fixed partial denture treatment. For the advantages of
is due to pulp stimulation by way of lack of cement
conventional crown or fixed partial denture, it has a
space, and in certain cases due to excessive reduction
definite and a larger scope since it can be afforded by
leading to fine pulp exposure.4
larger number of people. Keeping this in mind a clinical
The breakage of porcelain veneer is due to inadequate
survey was undertaken to assess the common causes of
space for the sufficient thickness of porcelain or due to
failures of crowns and fixed partial denture cases
of occlusal stresses from the opposing
reporting at our Institute by collecting the data
after
IJCD JANUARY,concentration
2011 2(1)
120
teeth. Dentistry
proper clinical examination and diagnosis. 2011 Int. Journal of Contemporary
In 3 cases, it was observed that the restoration had

RESEARCH
No. of
Units
39

Percentage

Type of failure3

44.82%

Class I / II .

21

24.13%

Class IV

13

14.94%

Class III

4.

Breakage of restoration / facing /


porcelain veneer
Breakage of supporting tooth.

03

3.44%

Class V

5.

Esthetic deficiency.

05

5.74%

Class III

6.

Food impaction in embrasure areas /


bad odor

04

4.59%

Class III

7.

High spots.

02

2.30%

Class I

S.no
1.
2.
3.

Nature of failure
Looseness and poor retention./
repeated dislodgement
Pain under the restoration i.e. under
crown or fixed Partial denture

Table 1: Frequency of various types of failures of crown and fixed partial dentures.

concentration of occlusal stresses from the opposing


teeth.5
In 3 cases, it was observed that the restoration had
broken with the fracture of abutment tooth at the
cervical area. This can be attributed mainly to
weakened tooth structure due to root canal treatment
and also to excessive reduction of tooth during
preparation. Such teeth can break off under heavy
masticatory stresses during excursive movements.
Esthetic deficiencies mainly related to incorrect
proportioning in size and shape of teeth, particularly in
anterior fixed partial dentures, and also to the eruption
profiles of pontics.
The failures related to food impaction and bad odors
were due to incorrect design of pontics, lack of tight
contact with adjacent teeth, and incorrect gingival
margins.
Similarly the high spots were due to lack of adjusting
occlusion in excursive mandibular movements.
It can be safely said that nearly 77% of failures are due
to mechanical problems and only about 23 % are due to
oral diseases.1

Summary and Conclusion


The conventional crown and fixed partial denture
treatment modality being a very commonly practiced
and highly successful in restoring the functions of lost or
missing teeth and thereby the comfort of individual a
care must be taken to avoid the common causes leading
to their failures. In this endeavor, the proper selection
of the case, careful diagnosis, meticulous preparation,
and a professional construction of prosthesis are
mandatory to success and longevity of restoration and
maintenance of health of biological investing tissues.

121

References
1) Joanne N. Walton; F. Michael Gardner; John R.
Agar A survey of crown and fixed partial
denture failures; J.Prosthet., Dent; October
1986; vol. 56, issue 4; 416- 421.
2) Lindquist F. Karlsson S.- Success rate and
failures for fixed partial dentures after 20 years
of service; Part 1; Int.J.Prosthodont.;1998;MarApr;11 (2); 133 8.
3) Manappallil J.J. Classification system for
conventional crown and fixed partial denture
failures; J. Prosthet. Dent.; 2008; Apr.; 99
(4);293 8 .
4) Charles J. Goodacre; Guillermo Bernal, et.al. Clinical complications in fixed prosthodontics; J.
of Prosthet. Dent.; 2003, July, 90 (1), 31 41.
5) Alex Selby Fixed prosthodontic failure; A
review and discussion of important aspects
Australian Dental Journal.; 1994, June, vol. 39,
(3); 150 -6.
6) Lamiaa Sayed Kheiralla , Mona Attia , et.al.Failure of crown and fixed partial denture in
Fixed Partial Prosthodontics Dept.; Egyptian
Dental Journal,2007 , April , Vol.53,(2.1)
About the Author

Dr. Sudhir Pawar,


Professor and Head , Dept. of Prosthodontics,
Rungta College of Dental Sciences and Research;
Bhilai, Chattisgad. 490 024.
email: sudhirpawar56@gmail.com

Address for Correspondence


IJCD JANUARY, 2011 2(1)
2011 Int. Journal of Contemporary Dentistry