RESEARCH
Failures of crown and fixed partial dentures - A clinical
survey
Sudhir Pawar
ABSTRACT
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
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
Demand to replace the lost or missing teeth by means
of fixed partial denture has been ever increasing. Since
a fixed prosthesis assures the greater retention and
stability in addition to comfort, it is more or less
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
order to prepare the tooth or teeth for receiving the
retainers or a restoration as the case may be. Given the
other modality of having a fixed prosthesis by means of
taking support from implant is picking up, the same may
not be in the reach of many for reasons like financial
affordability, lack of available facilities in nearby
surroundings, as well as non willingness to undergo
surgical procedures and so on. Implant supported
crown or fixed partial denture has a distinct advantage
of sparing the natural tooth structure from that of
abutment teeth as required in conventional crown or
2
fixed partial denture treatment. For the advantages of
conventional crown or fixed partial denture, it has a
definite and a larger scope since it can be afforded by
larger number of people. Keeping this in mind a clinical
survey was undertaken to assess the common causes of
failures of crowns and fixed partial denture cases
IJCD • JANUARY,concentration
reporting at our Institute by collecting the data after
proper clinical examination and diagnosis. © 2011 Int. Journal of Contemporary
reporting at our Institute by collecting the data after
proper clinical examination and diagnosis.
Method and Materials
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
68 while the number of failures in case of fixed partial
dentures was 19.
The types of failures3 were categorized, tabulated and
Discussion
The most common cause of failure in crown and fixed
partial dentures was the lack of retention amounting to
45 %, which can be attributed to various causes like
improper preparation of tooth with too much taper of
proximal walls, one of the proximal walls being too
short, and lack of resistance form.4,5 It can also be
attributed to improper cementation and lack of
adjustment of occlusion during eccentric mandibular
movements6.
The most common cause of pain under the restorations
is due to pulp stimulation by way of lack of cement
space, and in certain cases due to excessive reduction
leading to fine pulp exposure.4
The breakage of porcelain veneer is due to inadequate
space for the sufficient thickness of porcelain or due to
2011 • 2(1) of occlusal stresses from the opposing
120
teeth. Dentistry
In 3 cases, it was observed that the restoration had
 RESEARCH
S.no Nature of failure No. of Percentage Type of failure3
Units
1. Looseness and poor retention./ 39 44.82% Class I / II .
repeated dislodgement
2. Pain under the restoration i.e. under 21 24.13% Class IV
crown or fixed Partial denture –

3. Breakage of restoration / facing / 13 14.94% Class III

porcelain veneer
4. Breakage of supporting tooth. 03 3.44% Class V

5. Esthetic deficiency. 05 5.74% Class III

6. Food impaction in embrasure areas / 04 4.59% Class III

bad odor

7. High spots. 02 2.30% Class I

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

concentration of occlusal stresses from the opposing

teeth.5
References
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
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;Mar-
Apr;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)

The conventional crown and fixed partial denture

treatment modality being a very commonly practiced About the Author
and highly successful in restoring the functions of lost or
missing teeth and thereby the comfort of individual a Dr. Sudhir Pawar,
care must be taken to avoid the common causes leading Professor and Head , Dept. of Prosthodontics,
to their failures. In this endeavor, the proper selection
Rungta College of Dental Sciences and Research;
of the case, careful diagnosis, meticulous preparation,
and a professional construction of prosthesis are Bhilai, Chattisgad. 490 024.
mandatory to success and longevity of restoration and
maintenance of health of biological investing tissues. email: sudhirpawar56@gmail.com

Address for Correspondence

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