PONTICS

SYNOPSIS

 INTRODUCTION

 DEFINITION

 REQUIREMENTS

 CLASSIFICATION OF PONTICS

 PRETREATMENT ASSESSMENT

 DESIGN CONSIDERATIONS

 Pontic modification

 PONTIC FAILURE

 CONCLUSION
 INTRODUCTI
ON

Pre operative Post operative

DEFINITION
ACCORDING TO :
 GPT-9

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.
 TYLMAN

The suspended member of a fixed partial denture

which replaces the lost natural tooth, restores function and
occupies the space of the missing tooth.
 REQUIREMENTS

 Pressure free contact on the ridge

 No irritation to the gingival tissues

 Restore function mastication, speech

 Color stable
 REQUIREMENTS

 Smooth surfaced

 Easily cleansable and facilitate plaque control

 Be esthetic and emergence profile

 Strength and longevity

 CLASSIFICATION
 DEPENDING ON THE MUCOSAL CONTACT:
 MUCOSAL CONTACT
 Ridge Lap
 Modified Ridge Lap
 Ovate
 Conical
 Saddle
 NO MUCOSAL CONTACT
 Sanitary(hygenic)
 Modified Sanitary
 Based on materials used

 Metal and porcelain veneered

 Metal and resin veneered

 All metal pontic

 All ceramic pontic

 METHOD OF FABRICATION
Custom made pontic Prefabricated pontic

Trupontic

Interchangeable facing

Sanitary pontic

Pin facing pontic

Modified pin facimg

Reverce pin facing

Harmony pin facing pontic

8.Porcelain fused to metal

 PRETRETMENT
ASSESSMENT
 PONTIC SPACE

 RESIDUAL RIDGE CONTOUR

 GINGIVAL ARCHITECTURE PRESERVATION- socket

preservation or alveolar architecture preservation tech

PONTIC SPACE

Drifting / tilting

Reduced pontic space

Difficulty in fabricating pontic

Trap food

Difficult to clean
Orthodontic movement to regain
space

Contouring the proximal surface to

compensate for reduced space
 RESIDUAL RIDGE
CONTOUR
Features of Ideal Ridge

Contour:
 Smooth and regular surface of attached gingiva -Facilitate

maintenance of plaque-free environment

 Sufficient height and width -Mimic adjacent tooth contours-

Appear to emerge from the ridge

Maintaining the gingival contour for establishing

good emergence profile
 LOSS OF RESIDUAL RIDGE CONTOUR:
• Unesthetic open gingival embrasures
• Food impaction
• Percolation of saliva during speech

Black triangle seen Food impaction

interdentally
SIEBERT’S CLASSIFICATION OF
RESIDUAL RIDGE DEFORMITIES
Class I defects
Faciolingual loss of
tissue width with
normal ridge height.
Class II defects
Loss of ridge height
with normal ridge
width.
Class III defects
A combination of loss
in both dimensions.
 ROLL TECHNIQUE

Facial
Lingual
aspect

Rolled on and
inserted
POUCH TECHNIQUE

Split thickness
flap reflected

Graft
material
placed in the
pouch
 Wedge shaped graft
in position

INTERPOSITIONAL GRAFT
TECHNIQUE

Striation cuts
made on
connective tissue

ONLAY GRAFT
GINGIVAL ARCHITECTURE
PRESERVATION

Provisional FPD with ovate

tissue form

Providing good emergence profile

PRINCIPLE CONSIDERATIONS
IN DESIGNING A PONTIC
BIOLOGIC
CONSIDERATIONS
Ridge contact
Oral hygiene considerations
Pontic material
Occlusal forces

MECHANICAL
ESTHETIC CONSIDERATIONS
CONSIDERATIONS Rigid
1.Emergenc profile Strong connector
-The gingival interface Strong framework
2.Shape of tooth it
replaces-Incisogingival
Length
Mesiodistal Width
3. Sufficient space for
porcelain
 BIOLOGIC
CONSIDERATIONS

 The biologic principles of pontic design pertain to the

maintenance and preservation of the residual ridge,

abutment and opposing teeth, and supporting tissues.

 RIDGE CONTACT

Active tissue contact leading

to ulceration

Blanching of tissues
 ORAL HYGIENE
CONSIDERATIONS

Pontics should provide access to oral

hygiene aids
 PONTIC MATERIAL
 Good esthetics

 Rigidity and strength to withstand occlusal forces

 Longevity

 Biocompatibility

Biocompatibility of materials used to fabricate pontics

have centered on two factors :

1. The effect of the materials to the surrounding tissues and

2. The effects of surface adherence

 OCCLUSAL FACTORS
 Narrowing the occlusal table may actually impede the
development of a harmonious and stable occlusal
relationship

 Difficulties in plaque control and improper cheek support.

 Pontics with normal occlusal widths are generally

recommended.

 One exception is when the residual alveolar ridge has

collapsed buccolingually. Reducing pontic width may then
be desired, thereby lessening the lingual contour and
facilitating plaque control measures .
 MECHANICAL
CONSIDERATIONS

 Factors that lead to fracture of prosthesis or displacement of

retainers:

1. improper choice of material

2. poor frame work design

3. poor tooth preparation

4. poor occlusion
 Evaluating the likely forces on a pontic and designing

accordingly are important

 ESTHETIC
CONSIDERATIONS

 1. The gingival interface

 2. Incisogingival Length
 3. Mesiodistal Width
 GINGIVAL INTERFACE
 An esthetically successful pontic will replicate the form,

contour, incisal edge, gingival embrasures and color of

adjacent tooth.
 INCISOGINGIVAL LENGTH
 Ridge resorption will make the tooth look too long in cervical region.

 Appearance can be improved by recontouring gingival half of labial

surface.

 Pontic can be shaped to simulate a normal crown and root with

emphasis on CEJ

 Pink porcelain

 Ridge augmentation
Gingival porcelain
MESIODISTAL WIDTH

Altered mesiodistal width due to drifting

of adjacent tooth
 SANITARY PONTIC
 Hygienic or Wash through pontics

• Zero tissue contact and adequate space for cleaning

• Occlusalgingival thickness should be atleast 3mm

• Space beneath the pontic – 2mm ( Rosenstiel)

- 3 mm ( Tylman)

 Mandibular posteriors
 TYPES

Convex buccolingually and Modified sanitary or perel or arc fixed pontic

mesiodistally- fish belly Hyperparaboloid-concave mesiodistally and
convex buccolingually
 Indication – non esthetic zone impaired oral hygiene

conditions.

 Contraindication – replacing teeth in esthetic zone.

 Disadvantage – patient may have tongue habits,

least resemblance to teeth and poor

esthetics

 Advantage – provides adequate access to abutment teeth for

good hygiene maintenance .

 SADDLE PONTIC
 The concave gingival surface overlaps the ridge bucally and

lingually – good esthetics - anteriors

 Gingival surface will not have continuous contact with the

ridge instead only the buccal and lingual surface will

contact the ridge

 Difficulty in maintenance

 Ulceration and inflammation

 RIDGE LAP PONTIC
 Resembles natural teeth

 Designed to adapt closely to the ridge

 Satisfies esthetics but not hygienic and difficult to maintain

 Often leads to inflammation of tissue

 MODIFIED RIDGE LAP
PONTIC OR
 The modified ridge lap pontic combines the best features of
the hygienic and saddle pontic designs, combining esthetics
with easy cleaning.
 Tissue contact is limited to the buccal surface of the ridge
 Recommended in anteriors and maxillary posteriors
 T shaped tissue contact- vertical arm- crest and horizontal
arm- buccal surface of the ridge
LAP FACING PONTIC
 Customized ridge lap pontic design
 In pts with nervous habits who show irritation on
the lingual surface
 Further modified called lap facing
 CONICAL PONTIC
 Egg-shaped, bullet shaped, or heart-shaped

 Convex with only one point of contact at the center of the

residual ridge.
 Recommended for the replacement of mandibular posterior

teeth where esthetics is a lesser concern.

 A knife-edged residual ridge will necessitate flatter contours

with a narrow tissue contact area.

 This type of design may be unsuitable for broad residual

ridges, because the emergence profile associated with the

small tissue contact point may create areas of food

entrapment
 OVATE PONTIC
 Most esthetically appealing

 Its convex tissue surface resides

in a soft tissue depression or

hollow in the residual ridge,

which makes it appear that a tooth

is literally emerging from the

gingiva
 Socket-preservation techniques should be performed at the
time of extraction to create the tissue recess from which the
ovate pontic form will emerge.

 For a preexisting residual ridge, soft tissue surgical

augmentation is typically required. When an adequate
volume of ridge tissue is established, a socket depression is
sculpted into the ridge with surgical diamonds

 Can be used in broad and flat ridge

MODIFIED OVATE PONTIC
 Liu
 Apex more facially than the crest of the ridge
 Conditions wr the horizontal ridge width is not
sufficient
 Cleaning also easier
 ROOT FORM
 LANCEBERG
 NATURAL TOOTH PONTICS
PONTIC MODIFICATION
 Nal pg 629
PREFABRICATED PONTICS

Trupontic Pin facing pontics

49
Reverse pin facing pontics Harmony pin facing
Interchangeable facing
pontics
 PONTIC FAILURE
 BIOLOGICAL FAILURE:

Over carved or under carved occlusal surface may

impair functional efficiency

Unglazed surface- plaque accumulation

 MECHANICAL FAILURE :

May occur because of inadequate strength. The

framework must provide a uniform veneer of porcelain
Excessive thickness of porcelain contributes to inadequate
support and predisposes to eventual fracture.
 ESTHETIC FAILURES

 Dark space in cervical third due to improper pontic

selection especially in the anteriors

 Improper shade selection

 Excessive metal thickness at incisal and cervical regions

 Thick opaque layer application

 Over glazing or too smooth a surface

 CONCLUSION

 The pontic design determines the success or failure of a fixed

partial denture.

 Minimizing the tissue contact by maximizing the convexity

of the pontic’s gingival surface is essential.

 Special considerations must be given to create a design that

combines easy maintenance with natural appearance and

adequate mechanical strength.

 REFERENCES

 Contemporary fixed prosthodontics. Rosestiel. 3rd Edition.

 Fundamentals of fixed Prosthodontics. Shillingburg 3rd Edition.
 Tylman’s Theory and practice of fixed prosthodontics. 8th edition
 Antony H L: A sanitary “ Arc- fixed partial denture” : Concept
and technique of pontic design. J Prosthet Dent 1983; 50: 338
 Henry P J et al: Tissue changes beneath fixed partial dentures. J
Prosthet Dent 1966; 16: 937