Frequency of Porcelain Fracture in Patients with Bruxism Reporting to the Department of Prosthodontics Bacha Khan College of Dentistry

Abstract

Background: Bruxism increases the risk of mechanical complications in porcelain-based restorations, potentially affecting their longevity.

Objective: To determine the prevalence and associated factors of porcelain fracture among bruxism patients presenting to the Department of Prosthodontics, Bacha Khan College of Dentistry, Mardan.

Methodology: This six-month cross-sectional study included 154 patients aged 18–60 years diagnosed with bruxism who had porcelain-based restorations placed at least three months prior. Bruxism was diagnosed based on self-reported morning jaw pain (VAS > 3), morning headaches (VAS > 3), and pain/discomfort during chewing, in accordance with symptom-based criteria used in clinical cross-sectional research in resource-limited settings. Clinical examination assessed the presence, location, and severity of porcelain fractures. Data were analyzed using SPSS version 27. Chi-square and logistic regression tests evaluated associations between incidence of fracture and type of bruxism, restoration type, restoration age, and gender (p ≤ 0.05).

Results: The prevalence of porcelain fracture was 63.6% (98/154). Fractures occurred exclusively in metal-ceramic crowns, where the within-group fracture rate was 96.1% (98/102) (p < 0.001).  Nocturnal bruxism and restorations older than five years were significantly associated with fractures (p < 0.001; p < 0.01). Gender showed no significant association (OR = 0.67; 95% CI: 0.346–1.296; p = 0.234). Most fractures involved posterior teeth (79.6%), with over half requiring replacement.

Conclusion: Porcelain fractures were observed exclusively in metal-ceramic crowns among bruxism patients in this single-center cross-sectional study. Nocturnal bruxism and restoration age exceeding five years were significantly associated with fracture occurrence. These findings should be interpreted in light of study limitations and confirmed by future longitudinal research.