PONTICS

PONTICS

-VAISHAKHI .Y. BAISANE(IVth YEAR B.D.S)

-VAISHAKHI .Y. BAISANE(IVth YEAR B.D.S)

CONTENTSDEFINITIONIDEAL REQUIREMENTSPONTIC DESIGNPRETREATMENT ASSESSMENTPONTIC CLASSIFICATION BIOLOGICAL CONSIDERATIONSMECHANICAL CONSIDERATIONSESTHETIC CONSIDERATIONSPONTIC FABRICATIONREFERENCES

DefinitionPontic is defined as an artificial tooth on a

fixed dental prosthesis that replaces a missing natural tooth , restores its function and usually fills the space previously occupied by the clinical crown.

Ideal RequirementsA pontic should restore the function of the

tooth it replaces .It should provide good esthetics.It should be biocompatible with continued

oral health and comfort.It should permit effective oral hygiene.It should preserve underlying mucosa and

bone.

Pontic designThe success of a F.P.D depends on the proper design

of the pontic.The pontic must be carefully designed and fabricated

not only to facilitate plaque control of the tissue surface and around the adjacent abutment teeth but also to the existing occlusal considerations .

The design of pontic depends on various factors: Pretreatment assessment , Pontic classification , Biological considerations , Mechanical considerations and Pontic fabrication .

Pretreatment assessmentCertain procedures enhance the success of

pontics they are: pontic space residual ridge contour gingival architecture preservation

Classification of ponticsPontic design are classified into two major

groups: Those that contact the oral mucosa Those that do not Based on type of materials for fabrication Based on method of fabrication Pontic selection is based primarily on

esthetics and oral hygiene.

MUCOSAL CONTACT : Ridge lap Modified ridge lap ovate conicalNO MUCOSAL CONTACT : Sanitary/ hygienic Modified sanitary/ hygiene

Based on type of material used : metal and porcelain veneered pontic metal and resin veneered pontic all metal all ceramic

Based on method of fabrication : Custom made pontic Prefabricated pontic : trupontic interchangable facing sanitary pontic pin facing pontic modified pin facing pontic reverse pin facing pontic harmony pontic porcelain fused to metal pontic Custom made prefabricated pontic

PONTIC DESIGN

MATERIALS LOCATION

SANITARY/HYGIENIC

All metal Posterior mandible

SADDLE-RIDGE-LAP

Not recommended

Not recommended

CONICAL All metalMetal ceramicAll resin

Molars without esthetic requirement

MODIFIED RIDGE-LAP

All metalMetal ceramicAll resin

High esthetic requirement

OVATE All metalMetal ceramicAll resin

Very high esthetic requirement

PONTIC DESIGN ADVANTAGES DISADVANTAGESSANITARY/HYGIENIC

Good access for oral hygiene

Poor esthetics

SADDLE-RIDGE-LAP esthetic Not amenable to oral hygiene

CONICAL Good access for oral hygiene

Poor esthetics

MODIFIED RIDGE-LAP

Good esthetics Moderately easy to clean

OVATE Superior esthetics Negligible food entrapmentEase of cleaning

Requires surgical preparationNot for residual ridge defects

PONTIC DESIGN INDICATIONS CONTRAINDICATIONS

SANITARY/HYGIENIC

Non esthetic zonesImpaired oral hygiene

Where esthetics is essentialLess vertical dimension

SADDLE-RIDGE-LAP Not recommended Not recommendedCONICAL Posterior areas where

esthetic is minimal consideration

Poor oral hygiene

MODIFIED RIDGE-LAP

Most areas with esthetic consideration

Where minimal esthetic consideration exists

OVATE Desire for optimal estheticsHigh smile line

Unwillingness for surgeryResidual ridge defects

Design considerations for posterior pontic : All surfaces should be convex , smooth and properly

finished. Contact with buccal slope of ridge should be

minimal and pressure free. The occlusal table should be in harmony with the

occlusion of all the other teeth. The buccal and lingual shunting mechanism should

correspond with that of the other teeth. The overall length of the buccal surface should be

equal to that of the adjacent abutments or pontics

Design considerations for anterior pontic : All surfaces should be smooth , convex and

properly finished . Contact with labial slope of the ridge should be minimal and pressure free.

A large contact with the ridge is provided for a natural look.

Lingual contour should be in harmony with that of the other teeth.

Considerations for successful pontic

biologic

mechanical

esthetic

BIOLOGIC: Ridge contact Oral hygiene considerations Pontic material Occlusal forces

Mechanical : Available materials Strong connectors Metal ceramic framework Rigidity

Esthetic : Incisogingival length Mesiodistal width Gingival interface

AVAILABLE PONTIC SYSTEMS

ADVANTAGES

DISADVANTAGES

INDICATIONS

CONTRAINDICATIONS

METAL-CERAMIC

ESTHETIC BIOCOMPATIBLE

DIFFICULT WHEN ABUTMENT IS NOT METAL-CERAMIC WEAKER THAN ALL METAL

MOST SITUATIONS

LONG SPANS WITH HIGH STRESS

ALL METAL STRENGTH STRAIGHTFORWARD PROCEDURE

NONESTHETIC MANDIBULAR MOLARS ESPECIALLY UNDER HIGH BITE FORCE

WHERE ESTHETICS IS IMPORTANT

FIBRE REINFORCED ALL RESIN

CONSIDERATIVE WHEN USED WITH INLAY PROCEDURE ESTHETICS EASE OF REPAIR

LIMITED TO SHORT SPANS

AREAS OF HIGH ESTHETIC CONCERN

LONG SPAN PARTIAL FIXED DENTAL PROSTHESIS

SANITARY PONTIC :It allows easy cleaning as the tissue surface remains

clear of the residual ridge. The hygienic pontic is the least tooth like structure

hence it is reserved for teeth seldom displayed during function.(mandibular molars for example)

These pontics have zero tissue contact. The pontic should allow adequate tissue clearance

and should be atleast 3mm high occlusogingivally.

Three common designs can be employed while fabricating a sanitary pontic :

Bar sanitary pontic - they have flat gingival surface and sufficient gingival clearance

Conventional or fish-belly pontic – the gingival surface of pontic is convex both buccolingually and mesiodistally . Its disadvantages are that size of connector is reduced and so strength of prosthesis is also reduced.

Modified sanitary or perel pontic or arc-fixed pontic – the gingival surface is hyperparaboloid that is concave mesiodistally and convex buccolingually.

It overcomes the limitations of fish belly pontic and is easier to maintain also the arch shape increases the size of the connectors .

SADDLE PONTIC : A Pontic with a concave surface which

overlaps the ridge buccally and lingually is called a saddle .

Ginival surface of the saddle pontic does not have contact with the ridge , only buccal and lingual ends of the gingival surface will contact the tissue .

Disadvantage of this pontic is the difficulty in maintenance.

RIDGE-LAP PONTICS : It resembles a natural tooth . Its design is closely adapted to the ridge . It is avoided as it is difficult to maintain and it

is leads to inflammation of tissues quite often .

MODIFIED RIDGE-LAP PONTICS : They were designed to reduce further tissue contact . This pontic is designed with a slight buccolingual cavity

wherin food entrapment can occur . Food entrapment is avoided by designing a convex

mesiodistal surface . Tissue surface of the pontic shows a T shaped contact . The vertical arm of the ‘T’ ends at the crest of the ridge. The horizontal arms form contact along the buccal

surface of the ridge . Contact with buccal surface of the ridge is to provide a

natural appearance .

OVATE PONTICS : These pontics are used in cases where the residual

ridge is defective or incompletely healed . They can also be used in broad and flat ridges . The pontic is such designed that its cervical end

extends into the defect of the edentulous ridge . The pontic should be reduced as healing

progresses. This pontic is more esthetic as it appears to arise

from the ridge like a natural tooth .

CONICAL PONTIC : It can also be called egg shaped or bullet shaped or

heart shaped pontic . It should be made as convex as possible with only one

point of contact at the center of the residual ridge . This design is recommended for replacement of

mandibular posterior teeth , where esthetic concern is less .

Only disadvantage is poor esthetics which results due to wide embrasures.

REFERENCESROSEN-STIELSHILLINGBURG

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