Fixed Dental Prostheses Esthetic Failures and Management

Introduction:

In fixed dental prosthesis we have three principles of tooth preparation

which is :
1-Biologic considerations which affect the health of the oral tissuse
2-Mechanical consideration which affect the integrity and durability of the
restoration
3-Esthetic considerations which affect the appearance of the patient

In this paper we are going to discuss about the failures and management
of the 3rd principle.

Esthetic failures:

Ceramic restoration more often fail esthetically than mechanically or

biologically.
 Colour Mismatch:
Main reason reported by dental laboratories is poor colour match.
This could be the result of:-
o Inability to match the patient’s natural teeth with available porcelain
color
o Inadequate shade selection
o Due to metamerism
o Insufficient tooth reduction or failure to properly apply and fire the
porcelain may have created a restoration that does not match the
shade guide or surrounding teeth.
o Because incorrect form or framework design that displays metal
o In addition, natural teeth undergo color changes that do not occur
in porcelain, so that an unacceptable color match is caused over
the years.
o The marginal fit or cervical form of a prosthesis can promote
plaque accumulation, causing gingival inflammation, which
produces an unnatural soft tissue color or form that is esthetically
unacceptable.

Removing of Crown and Bridges:

- Before removal possible need for temporary crown must be
remembered and provision for this should be made.
- Important is to protect the airway as chances of inspiration is
more due to the small size of crown, bridge particularly inlays.
Alter chair position and make patient sit upright.
- Attempt to remove the prosthesis intact, if not possible
prosthesis is cut until the prepared tooth is exposed and then
removed.
- Preparing the slot lingually is advantageous as material bulk on
the lingual side is comparatively less and therefore easily
removed. As slot is on the lingual side the same prosthesis can
be used as a temporary crown.
- Usually facial slots work best for maxillary and mandibular
Molars