Prosthetic work is intended to restore the functions of the dento-maxillary apparatus, lost with the deterioration of dental units.
From improving chewing and phonation to restoring aesthetics, dental crowns play a major role in maintaining the balance of the whole body.
If these restorations target the frontal area, their deterioration produces considerable psychological repercussions.
The patient may feel self-conscious in social situations or even isolate himself, refusing contact with other people precisely because of this problem.
This only accentuates the sense of inferiority felt by the patient.
In general, patients who care about their general health but also about the integrity of their body and its functions will go to the dentist as a matter of urgency in case of injuries that damage the front group of teeth.
Edentations or lesions that cause extensive destruction affect mastication, phonation and aesthetics.
Loosening of the prosthetic work in the front areas may be due to compressive forces that cause changes in the cementing material. On the other hand, some compromises made during the clinical and technical stages may also have consequences on the finished piece.
Risk factors
The risk factors that contribute to the de-cementing of dental crowns are the following:
Lack of retention of the prosthetic piece to the prosthetic abutment – there may be defects in the tooth surfaces which, with correction, solve the problem. There is a situation where the prosthetic piece is much wider than the tooth to which it is attached and by applying a thicker layer of cementing material, its strength is weakened.
Defects at the time of cementation – the cementation of a prosthetic work must respect an environment isolated as far as possible from oral fluids. Saliva penetration either by tongue wandering during the cementing process or by lack of isolation with cotton wool rolls can lead to compromised adhesion.
Patient occlusal problems – deficiencies in the patient’s occlusion caused by dental, muscular or bony abnormalities can lead to para-axial, inconsistent forces, which contribute to the dehiscence of prosthetic work.
Evolution of a caries on the prepared tooth – teeth must be prepared for crowns.
This means reducing the overall size of the teeth by about 2 millimeters for ceramic crowns.
If the teeth undergo carious processes, these must be thoroughly cleaned and filled because once the ceramic crown is applied, any active carious process can erode further from the tooth surface, leading to the removal of the prosthetic crowns.
Lack of adhesion of the cementing material to the tooth surface – the cementing material is interposed between two surfaces, the teeth and the prosthetic work. Inadequate cleaning of these two planes or chemical interference can lead to poor adhesion which, over time, can promote loosening.
The patient may be able to tell for themselves the poor adhesion between the prosthetic restoration and the tooth by the appearance of mobility.
Halitosis may also be a sign of infiltration of cementing material.
On the other hand, if the denture is over cemented, i.e., the patient feels that it closes on that denture tooth first and only then on the rest, it may be due to partial loosening of the denture.
Prosthetic work is intended to restore the functions of the dento-maxillary apparatus, lost with the deterioration of dental units.
