An anterior fixed bridge has caries in the abutment teeth, a loose retainer, and a visible marginal discrepancy. What is the appropriate management?

Correct answer: A. Remove the bridge, treat the caries, and fabricate a new prosthesis

• A. Correct. When a fixed prosthesis has a LOOSE retainer, MARGINAL misfit AND abutment CARIES, the restoration has failed and must be REMOVED. A loose retainer on a multi-unit bridge is particularly dangerous because it allows undetected caries to progress rapidly beneath a still partly retained framework. Sequence: remove the bridge, assess and excavate the caries, evaluate abutment restorability and pulp status, place provisional restorations, then plan the definitive prosthesis.
• B. Occlusal adjustment addresses none of the three problems identified.
• C. Recementing a bridge over active caries seals bacteria against the abutment and guarantees progression to pulpal involvement.
• D. Access for adequate caries removal at the abutment margins is impossible with the bridge in situ, and the marginal defect would remain.