Don't forget that the result of Worlds that year was as much a result of unusual results in the compulsories and OD as the outcome of the FD. I think part of the reason K/P did not win in '91 is three-fold.
First, following Euros they unfortunately received a false positive drug test for a banned substance (steroid?) for Marina. The B sample later came back negative and they were exonerated. However, it took several weeks for the second set of test results to be completed. This left them under a cloud of suspicion that hampered their training and put them under extreme emotional strain. Not only was their European title in danger of being stripped, but their eligibility to compete at Worlds in a few weeks and in Albertville the next winter also hung in the balance.
Secondly, as a result of all the scrutiny, every little detail of their training and their programs was being nitpicked by the whole skating community and the general press at large. They had received a lot of negative press since 1990 Worlds based soley on the result of the FD almost implying that they had stolen the title from the D's simply b/c their program was not as edgy or popular (despite being technically superior). As a result, they decided to take a new choreographic route. They realized that their technique, though unquestionably better, was no longer enough in the eyes of the judges and the fans to keep them ahead. Still their new FD, while very difficult, was generally found to contain too many lifts (ironic since FD rule bending was commonly overlooked for the D's and virtually every other medal worthy team since the early 80's) and was viewed as a very drastic departure from their previous programs. Unfortunately, the concept of their program had a hit or miss impact with the skating community and the fans.
Third, K/P were in the process of disolving their long-standing relationship with their coach, Natalia Dubova, due to disagreements over what style of programs best suited them and how much decision-making power they could wield for themselves. Dubova favored more traditional routines for K/P since that was their trademark. Still at the same time, she devoted more engery and creativity to more modern programs for their training mates and rivals U/Z. This lead to feelings of jealously and favoritism and a terrible environment for training.
By the time Worlds began she was the coach in name only and was devoting much of her time to U/Z. This left them feeling very isolated with virtually no support from their coach and federation, a lingering cloud of doping charges hanging overhead and the weight of knowing that fans overwhelmingly favored the D's. Of course this all happened against the backdrop of the Soviety Union and its famed sports regime collapsing.
Due mainly to lack of training, Marina made uncharacteristic errors in the first CD (a segment they normally won easily) and skated very tightly in the second . This allowed U/Z to hold the lead with K/P in second and the D's in the third heading into the OD. The D's then skated what was probably their best OD of their career to place first with U/Z in second and K/P in third. The competition was very tight, the first two teams seemed to capture the mood of the dance better, while K/P were typically technically superior. Going into the FD, whoever won that segment would win overall. This was a first b/c Marina and Sergei had usually won the first two segments and had the luxury of finishing second in the FD and still winning the title. Pressed to choose between three avant garde FD's instead of the usual combo of one and two more traditional ones, the judges picked the D's and their Missing II (which almost everyone agreed largely contained recycled elements of their previous routines). In many ways, it was the safe choice since the judges were not yet used to the "new-look" Russians.
In many ways, this was probably the best thing that could happen for K/P. It made them hungry to regain their stature and relieved the burden of having to fend off the D's from catching them. They were forced to take stock and re-tool their approach, leave their coach and move to Tarasova who gave them the affirmation and nurturing they needed. For the D's , winning may have made them too conservative in their approach the following season as all their programs were far more traditional than one would have expected.