RESUMO
OBJECTIVE: Ceramic fracture is an undesirable outcome of the rehabilitation with fixed partial dentures (FPD), mainly because it may involve additional cost and clinical time for intraoral repair or replacement of the restoration. This clinical report describes a 5 years survival intraoral repair of a chipped porcelain veneered zirconia framework restoration using a resin-based composite. CLINICAL CONSIDERATIONS: A FPD of porcelain veneered zirconia was made. After 18 months, the FPD presented a porcelain chip (porcelain fracture without exposure to the zirconia structure) on the buccal side of the pontic. An epoxy resin replica of the fractured surface was obtained and was examined under scanning electron microscopy. Fracture origin was found at the cervical area of the pontic. Intraoral repair by bonding the chipped fragment back in place was performed. After 15 days, the porcelain fragment debonded without patient knowledge and the fragment was lost. Then, intraoral repair using composite resin to restore the fractured area was performed and is still in function to date. CONCLUSIONS: Based on the 5-years survival of the performed intraoral repair, the composite resin reconstruction technique has shown to be an adequate alternative treatment for fractured FPD. CLINICAL SIGNIFICANCE: A resin composite repair of the fracture site can be performed in one clinical session, using much less time and cost than for the replacement of FPD. This clinical case survived 5 years to date.
Assuntos
Porcelana Dentária , Zircônio , Materiais Dentários , Falha de Restauração Dentária , Prótese Parcial Fixa , HumanosRESUMO
OBJECTIVE: This article presents a retrospective analysis of an anterior single crown that showed chipping of the veneering ceramic, the clinical stages of intraoral repair made in composite resin, and fractographic analysis of the causes of failure. CLINICAL CONSIDERATIONS: The ceramic chipping occurred in the incisal and labial surfaces of the crown, 1 year after installation. Clinical examination revealed the presence of occlusal interference, which was probably responsible for chipping. Vinyl-polysiloxane impression was made from the patient, and epoxy replica was produced. The replica was gold coated and inspected under the optical microscopy and scanning electron microscope (SEM) for descriptive fractography. Optical microscopy and SEM images showed that chipping initiated at the incisal edge, where it is possible to note an area of damage accumulation. At the labial surface, multiple arrest lines with their convex sides facing the incisal edge were observed. The fractured area was repaired intraorally with composite resin, and the patient's occlusion was checked and monitored. CONCLUSION: According to the fractographic analysis, occlusal interference was related to ceramic chipping in the incisal edge. Intraoral repair technique with composite resin was indicated for this moderate chipping. CLINICAL SIGNIFICANCE: Retrieval analysis of chipping ceramic delivers better understanding of the failure origin and could prevent future failures. Intraoral repair is a practical and conservative technique and may be performed in a single clinical session without requiring the removal of prosthesis.