European Journal of Molecular & Clinical Medicine

ISSN 2515-8260 Volume 7, Issue 11, 2020

Assessment Of Causes Of Failures Of Fixed

Partial Denture Running Title: FPD Failure

1. Maitree Patel
Manipal College of Dental Sciences, Manipal (2019)

2. Priyanka Sharma *
D Y Patil School of Dentistry, Navi Mumbai, Maharashtra (2020)
*Corresponding Author - 8082452378

3. Srikavya Tippadamppally
Panineeya Institute of Dental Sciences & Research Center, Hyderabad, Telangana (2019)

4. Esma Sheikh
BDS - Vasantdada Patil Dental College, Sangli
Internship - Nair Dental Hospital & College, Mumbai, Maharashtra 2020

5. Shreya Ghatekari
D Y Patil School of Dentistry, Navi Mumbai, Maharashtra

6. Rushil Patel
Intern, AMC Dental College, Ahmedabad, Gujarat

ABSTRACT
Background: The present study was conducted to assess causes of failures of FPD.
Materials & Methods: 142 patients of both genders who had FPD failures due to various
reasons were included. The cause of failure was recorded.
Results: Esthetic causes were over contoured margin in 12, under contoured margin in 6 and
unacceptable color match in 8 cases. Other causes of failures was loss of retention in 30,
periapical pathology in 12, bridge fracture in 10, caries in 8, coronal tooth fracture in 7,
occlusion problem in 5, porcelain fracture in 13, mobility of abutment in 5, perforation in 4,
food lodgement in 8, occlusal wear in 10 and sinus formation in 2 cases. The difference was
significant (P< 0.05).
Conclusion: Common cause of failures was under contoured, over contoured margin, loss of
retention and periapical pathology.
Key words: Caries, FPD, Over contoured margin

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Introduction

Replacement of missing teeth in partially edentulous arch involves various treatment options like
removable, fixed prosthesis, and implants. Fixed prosthodontic treatment can offer exceptional
satisfaction for both patient and dentist. Restoring and replacing of teeth with FPDs represents an
important treatment procedure in dental practice, mainly because of the continuing high
prevalence of caries and periodontal diseases in the adult and geriatric populations.1

A fixed partial denture is defined as a fixed restoration which replaces one or more missing teeth
and is attached to natural teeth or an implant. In case of improper treatment planning, they are
more likely to fail prematurely and lead to irreversible damage to the teeth and supporting
structures.2 In recent years, several investigators have taken great interest in investigating the life
span and long-term quality of fixed dental prosthesis. Some of the common failures in fixed
bridge prosthodontics are loose retainers, fracture of soldered joints, fracture of porcelain,
fracture of the abutment teeth or voids in retainer or pontic. Failure of theses restorations may
also lead to recurrent caries or loss of abutment teeth.3 Complications resulting from
rehabilitation treatment with prostheses are factors that may occur during or after treatment. The
dentist should know such complications, in order to be able to conclude a detailed diagnosis,
treatment planning and execution of procedures giving special attention to the most frequent
failure factors, and thus meeting the patient’s expectations and planning the post-treatment care
and maintaining.4

Most of the time, complications are conditions that occur during or after an appropriately
performed fixed prosthodontic treatment procedures. There are three main types of failures
Biologic failure, mechanical failure and aesthetic failure.5 Clinical failure may occur during or
after fixed prosthodontic treatment procedure. Failure and complications associated with fixed
prostheses include, but not limited to the loss of retention, caries, endodontic complications,
periodontal disease, tooth fracture or porcelain fracture, and unsatisfactory esthetics of the
prosthesis.6 The present study was conducted to assess causes of failures of FPD.

Materials & Methods

The present study was conducted in the department of Prosthodontics on 142 patients of both
genders who had FPD failures due to various reasons. All were informed regarding the study and
written consent was obtained. Ethical clearance was obtained from institutional ethical
committee.
General information such as name, age, gender etc. was recorded. The cause of failure was
recorded. Results thus obtained were subjected to statistical analysis. P value less than 0.05 was
considered significant.
Results
Table I Distribution of patients
Total- 142

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ISSN 2515-8260 Volume 7, Issue 11, 2020

Gender Males Females

Number 82 60

Table I shows that out of 142 patients, males were 82 and females were 60.
Table II Esthetic causes of failures

Causes Number P value

Over contoured margin 12 0.05
Under contoured margin 6
Unacceptable color match 8
Total 26

Table II, graph I shows that esthetic causes were over contoured margin in 12, under contoured
margin in 6 and unacceptable color match in 8 cases. The difference was significant (P< 0.05).

Graph I Esthetic causes of failures

Number
12
12

10
8
8
6
6 Number

0
Overcontoured Undercontoured Unacceptable color
margin margin match

Table III Other causes of failures

Other failure Number P value

Loss of retention 30 0.01
Periapical pathology 12
Bridge fracture 10

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Caries 8
Coronal tooth fracture 7
Occlusion problem 5
Porcelain fracture 13
Mobility of abutment 5
Perforation 4
Food lodgement 8
Occlusal wear 10
Sinus formation 2
Total 114

Table II, graph I shows that other causes of failures was loss of retention in 30, periapical
pathology in 12, bridge fracture in 10, caries in 8, coronal tooth fracture in 7, occlusion
problem in 5, porcelain fracture in 13, mobility of abutment in 5, perforation in 4, food
lodgement in 8, occlusal wear in 10 and sinus formation in 2 cases. The difference was
significant (P< 0.05).

Graph II Other causes of failures

Number
30
30
25
20
15 12 13
10 10
8 7 8
10
5 5 4
5 2 Number

Discussion

All-ceramic fixed partial dentures (FPDs) have been routinely used in clinical dentistry because
various all-ceramic materials have been introduced and available for a clinical use. Favorable

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clinical performance for all-ceramic systems, has been reported especially when they are used in
the anterior region. Clinical follow-up studies of patients treated with artificial crowns and fixed
partial dentures (FPD) (bridges) is mandatory to find out complications. Reports are extremely
valuable for the overall assessment of various factors considered significant to the longevity of
different restorations.7,8 The present study was conducted to assess causes of failures of FPD.

In present study, out of 142 patients, males were 82 and females were 60. Sajjan et al9 in their
study, a total of 158 patients were selected with complaints related to fixed dental prosthesis
(FDP). Site and condition of the prosthesis and its abutments were evaluated. Majority of failures
(32.27%) were found to be class III failure followed by class VI failure (24.05 %). 13.29 %
failures were Class IV, 12.65 % failures were identified as class II, 12.02 % failures as class V
and 5.69 % failures were categorized in class I failure.
We observed that esthetic causes were over contoured margin in 12, under contoured margin in 6
and unacceptable color match in 8 cases. In a study by Fayyad et al10, 75 patients contributing a
total of 309 units were included. Qualities of the present fixed partial dentures were clinically
and radiographically assessed. The results showed most common complication was shade
mismatch 64%, over-contoured 59.9%, open margins 49.8% and caries 40.1%. The number of
units and duration of service were found to influence most of the assessed complications. The
prevalence of complications was high among the studied sample.

We observed that other causes of failures was loss of retention in 30, periapical pathology in 12,
bridge fracture in 10, caries in 8, coronal tooth fracture in 7, occlusion problem in 5, porcelain
fracture in 13, mobility of abutment in 5, perforation in 4, food lodgement in 8, occlusal wear
in 10 and sinus formation in 2 cases. Rashedi11 in their study included 98 patients, with 44 FPD
and 54 single crowns. Patients were asked questions pertained to the period, nature of complaint,
and type of materials used. Clinical examination was performed. The percentage of the failures
were periodontal disease (51%), gingival bleeding (46.9%), open margins (43%), caries (41%),
shade mismatch (42%), occlusal wear of the opposing tooth (20.4%) prostheses loose (13%) and
porcelain or abutment fracture (12.2%). The duration of service was found to influence most of
the assessed complications especially periodontal disease, shade mismatch and occlusal wear.
Ericson et al12 contend the lifespan of a FPD is correlated with the number of retainers but not
with the number of units. This study found a decrease in the mean years of service as the number
of units in a FPDs increased. The mean year of service for a three-unit FPD was 8.6 years and
just 4.2 years for a six-unit FPD. In a study by Zavanelli et al13 the patients answered a
questionnaire about the satisfaction degree with dental treatment performed and care
maintenance for prosthesis conservation. Clinical and radiographic evaluations of the prosthesis
were performed. A total of 9.67% failures were found. The most common was the prosthesis
loosening (57.14%), followed by ceramic fracture (28.57%), and abutment tooth fracture
(14.29%). Biological failures were observed in 30.65%. The most common failure was gingival
recession (52.00%), periodontal pocket (24.00%), support periodontal involvement (16.00%),

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and recurrent caries (4.00%). Radiographic examination showed that 70.97% of the total number
evaluated had some kind of failure. There was statistically significant association between
satisfaction degree and technical failure (p=0.04).

Chandranaik et al14 in their study a total of 450 fixed partial denture failures in subjects were
assessed. The fixed partial denture was examined for the failure factors (biological, mechanical,
and esthetic). Out of 450 fixed partial denture failures, 33.3% of it showed the biological failure,
55.1% showed the mechanical failure and 11.5% showed esthetic failure. The most frequent
reason for failure was mechanical factors followed by biological and esthetic failure factors. The
caries was the most common biological failure factor, the loss of retention was the most common
cause of mechanical failure factor and the unacceptable color match was accounted more when
compared to other esthetic failure factors.

The limitation of the study is small sample size.

Conclusion

Authors found that common cause of failures was under contoured, over contoured margin, loss
of retention and periapical pathology.

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