Upon reviewing a porcelain-fused-to-metal (PFM) prosthesis, it is determined that the fit is poor and the margins are inadequate. Re-cementation is not possible. What should be done next?

Correct answer: B. Take alginate impressions to fabricate new study models

• A. Re-cementing a poorly fitting prosthesis with inadequate margins is contraindicated — it will result in secondary caries, periodontal problems, and further damage to the tooth structure.
• B. CORRECT. When a PFM prosthesis has poor fit and cannot be re-cemented, the next step is to take new impressions to fabricate accurate study models. Alginate impressions allow the dentist to evaluate the current clinical situation, assess the preparation, and plan for a new restoration. This is the appropriate diagnostic and treatment planning step before deciding how to proceed.
• C. Removing the PFM prosthesis comes before taking impressions — but if the prosthesis is still in place and the question is what to do 'next' after determining it cannot be re-cemented, obtaining impressions with the current clinical situation is the appropriate next step. Removal would follow as part of the treatment plan.
• D. Chairside adjustment with a bur on a poorly fitting PFM restoration that cannot be re-cemented is not appropriate — adjusting the restoration will not correct a fundamentally poor fit.