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      • Record: found
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      Removal of failed crown and bridge

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          Abstract

          Crown and bridge have life span of many years but they fail for a number of reasons. Over the years, many devices have been designed to remove crowns and bridges from abutment teeth. While the removal of temporary crowns and bridges is usually very straightforward, the removal of a definitive cast crown with unknown cement is more challenging. Removal is often by destructive means. There are a number of circumstances, however, in which conservative disassembly would aid the practitioner in completing restorative/endodontic procedures. There are different mechanisms available to remove a failed crown or bridge. But there is no information published about the classification of available systems for crown and bridge removal. So it is logical to classify these systems into different groups which can help a clinician in choosing a particular type of system depending upon the clinical situation. The aim of this article is to provide a classification for various crown and bridge removal systems; describe how a number of systems work; and when and why they might be used. A PubMed search of English literature was conducted up to January 2010 using the terms: Crown and bridge removal, Crown and bridge disassembly, Crown and bridge failure. Additionally, the bibliographies of 3 previous reviews, their cross references as well as articles published in various journals like International Endodontic Journal, Journal of Endodontics and were manually searched.

          Key words:Crown and bridge removal, Crown and bridge disassembly, Crown and bridge failure.

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          Most cited references29

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          A systematic review of the survival and complication rates of fixed partial dentures (FPDs) after an observation period of at least 5 years.

          Ken Tan, Bjarni E Pjetursson, Niklaus P Lang … (2004)
          The present study was done to determine the long-term success and survival of fixed partial dentures (FPDs) and to evaluate the risks for failures due to specific biological and technical complications. A MEDLINE search (PubMed) from 1966 up to March 2004 was conducted, as well as hand searching of bibliographies from relevant articles. Nineteen studies from an initial yield of 3658 titles were finally selected and data were extracted independently by three reviewers. Prospective and retrospective cohort studies with a mean follow-up time of at least 5 years in which patients had been examined clinically at the follow-up visits were included in the meta-analysis. Publications only based on patients records, questionnaires or interviews were excluded. Survival of the FPDs was analyzed according to in situ and intact failure risks. Specific biological and technical complications such as caries, loss of vitality and periodontal disease recurrence as well as loss of retention, loss of vitality, tooth and material fractures were also analyzed. The 10-year probability of survival for fixed partial dentures was 89.1% (95% confidence interval (CI): 81-93.8%) while the probability of success was 71.1% (95% CI: 47.7-85.2%). The 10-year risk for caries and periodontitis leading to FPD loss was 2.6% and 0.7%, respectively. The 10-year risk for loss of retention was 6.4%, for abutment fracture 2.1% and for material fractures 3.2%.
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            A survey of crown and fixed partial denture failures: length of service and reasons for replacement.

            Michael Walton, Martin Gardner, J R Agar (1986)
            The mean length of service of all restorations observed in this study was 8.3 years. Caries was the most common cause of failure, affecting 22.0% of the units failed and leading to the necessity for replacement of 24.3% of the units observed. Mechanical problems accounted for 69.5% of the failed units as opposed to 28.5% for oral disease. Resin veneer metal crowns provided the longest service of all crown types observed (13.9 years) and failed most frequently because of worn or lost veneers. The complete veneer metal crown had a life span of 6.1 years and was most likely to fail because of caries or defective margins. Ceramic-metal crowns also showed a relatively short period of service at 6.5 years, needing replacement primarily because of porcelain failure or poor esthetics. The resin-veneer metal crown also provided the longest service as a retainer, with a mean length of service of 14.7 years. This was closely followed by the partial veneer retainer (14.3 years), while the ceramic-metal retainer had the shortest life span (6.3 years). No apparent relationship was found between the span of prosthesis and its length of service. The six-unit canine-to-canine fixed partial denture exhibited the greatest longevity of the prostheses studied (10.4 years), while the two-unit cantilever fixed partial denture provided a mean of only 3.7 years of service before replacement was required.
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              Meta-analysis of fixed partial denture survival: prostheses and abutments.

              Mark S Scurria, James Bader, Daniel Shugars (1998)
              Few estimates of the probability of various outcomes associated with replacement of missing teeth with fixed partial dentures have been reported. Existing longitudinal studies have reported widely disparate results for the survival of fixed partial dentures, but these studies have used different definitions of failure and varying periods of follow-up. This study used meta-analysis to formulate annual probability estimates for three categories of fixed partial denture or abutment survival. A systematic review of the English language literature since 1960 identified eight studies that met the preset inclusion criteria. Estimated annual survival proportions were back-calculated based on the Kaplan-Meier model and these proportions were combined through a fixed effects model meta-analysis. The probabilities and corresponding 95% confidence intervals at 5, 10, and 15 years for the three categories of survival are reported. For the aggregate population represented by the limited longitudinal studies available, this meta-analysis indicated that less than 15% of fixed partial dentures were removed or in need of replacement at 10 years; whereas, nearly one third were removed or in need of replacement at 15 years. Less than 5% of abutments were removed at 10 years.
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                Author and article information

                Journal
                Journal ID (nlm-ta): J Clin Exp Dent
                Journal ID (iso-abbrev): J Clin Exp Dent
                Journal ID (publisher-id): Medicina Oral S.L.
                Title: Journal of Clinical and Experimental Dentistry
                Publisher: Medicina Oral S.L.
                ISSN (Electronic): 1989-5488
                Publication date (Electronic): 1 July 2012
                Publication date Collection: July 2012
                Volume: 4
                Issue: 3
                Pages: e167-e172
                Affiliations
                [1 ]BDS, MDS. Dept. of Prosthodontics. Bangalore Institute of Dental Sciences and Research Center. Bangalore, India.
                [2 ]BDS, MDS. Professor and Head of Department of Prosthodontics. Bangalore Institute of Dental Sciences and Research Center. Bangalore, India.
                [3 ]BDS, MDS. Professor, Department of Prosthodontics. Bangalore Institute of Dental Sciences and Research Center. Bangalore, India.
                Author notes
                Dept. of Prosthodontics Bangalore Institute of Dental Sciences and Research Center 5/3 Hosur Main Road, Opposite Lakkasandra Bus Stop Wilson Garden, Bangalore 560027 India , E-mail: drashu_sharma@ 123456yahoo.com
                Article
                Publisher ID: 50690
                DOI: 10.4317/jced.50690
                PMC ID: 3917642
                SO-VID: f3f09112-b138-428f-8fc1-c067fe81b35b
                Copyright © Copyright: © 2012 Medicina Oral S.L.
                License:

                This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date accepted : 19 April 2012
                Date received : 3 September 2011
                Categories
                Subject: Review
                Subject: Clinical and Experimental Dentistry

                Data availability:

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