1. POST
INSERTION
ADJUSTMENT

2. The following may be required after
cementation of the final restoration:
-Check the occlusion of the teeth
making sure that they are in their
correct intercuspation
-Remove again all existing
premature contacts after the
restoration has been seated
completely
-Make sure the gingiva is not
impinged

3. -Remove excess cements on the
surrounding soft tissues to avoid
inflammation
-Instruct the patient of the proper
home care procedures
-Regular recall appointments are required
to check the health of the tooth/teeth
and surrounding structures
-Seek the attention of the dentist in
cases of pain and discomfort after the
final installation of the denture

4. FOLLOW-UP CARE

5. Well-organized and
efficient follow-up care is the
chief mechanism for
ensuring successful fixed
prosthodontics.

6. A restoration that is
cemented, forgotten and
ignored is likely to fail no
matter how expertly it was
designed and executed.

7.  Restored teeth should
require careful plaque
removal and maintenance
than healthy unrestored
teeth. An FPD requires an
additional care and
attention.

11. Common Complications associated
after Completion of the Treatment:
(Post Insertion Problems)
 dental caries
 periodontal failure/disease
 endodontic failure
 occlusal dysfunction
 loose retainers
 porcelain fracture
 fractured connector
 pain

12. DENTAL CARIES
 Most common cause of failure of
a cast restoration
 Detection
is difficult particularly
where complete coverage is used

13. Undetected caries beneath this FPD

14. PERIODONTAL DISEASE
 Often occurs after placement of fixed
prostheses especially where the
cavosurface margin is placed
subgingivally or the prosthesis is over
contoured
 Inflammation is more severe with
poorly fitting restorations but even
perfect margins have also been
associated with periodontitis

16.  At recall appointments, attention is
given to sulcular hemorrhage,
furcation involvement and calculus
formation as early signs of
periodontal disease
 Improper contoured restoration
should be recontoured or replaced

17. OCCLUSAL DYSFUNCTION
 An examination of the occlusal
surfaces may reveal abnormal wear
facets
 Questions should be asked
concerning any parafunctional habits
such as BRUXISM
 Abnormal tooth mobility is
investigated and also muscle and
joint pain

18. If a cast restoration is not designed according to neuromuscular and
temporomandibular controls, extensive wear can result after a relatively
short time.

19. PULP AND PERIAPICAL
HEALTH
 Px may reveal having experienced one or
more episodes of pain which indicate the
loss of vitality of an abutment tooth/teeth
 Radiographs provide useful information
as to the presence of periapical pathosis
 Endodontically treated teeth should be
examined radiographically every few
years

20. PAIN
 Should be examined as to its
location, character, severity,
timing and onset
 Most oral pain is of pulpal origin

21. LOOSE RETAINERS
 Usually a sign of inadequate tooth
preparation, poor cementation
technique or caries
 In this case, the tooth/teeth require
repreparation and a new prosthesis
 The best policy is to section the
prosthesis rather than attempt to
remove it intact

22. A B
C D
(A) severe tooth destruction may result when a loose retainer goes undetected
(B) looseness of one retainer can occasionally be observed directly (arrow) when
force is exerted in an occlusal direction
(C) water is then applied to the cervical area, and the diagnosis is confirmed if
bubbles appear when pressure is exerted (D)

23. FRACTURED CONNECTOR
 Px may complain varying
degrees of pain due to extra
force transmitted to the
abutment teeth
 Wedges can be used to separate
individual components enough
to permit the correct diagnosis

24. Fractured connector

25. FRACTURED PORCELAIN VENEER
 Usually related to faulty framework
design, improper laboratory
procedures, occlusal functions or
trauma
 If porcelain has fractured but not
missing on a satisfactory
prostheses, repair than remake may
be justified with a porcelain repair
system utilizing silane coupling
agents to promote bonding with
acrylic/composite resin

26. Fractured porcelain
Repaired porcelain
using acrylic/
composite resin

27. SEE YOU ALL SOON
IN THE CLINIC!
GOODLUCK!!!
o
DR. VIVIAN C. CARLOS
Prosthodontics Section