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42540570-PONTICS

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PONTIC IN FPD
47
PONTICS VAISHAKHI .Y. BAISANE (IVth YEAR B.D.S)
Transcript

-VAISHAKHI .Y. BAISANE

(IVth YEAR B.D.S)

CONTENTS

DEFINITION IDEAL REQUIREMENTS PONTIC DESIGN PRETREATMENT ASSESSMENT PONTIC CLASSIFICATION BIOLOGICAL CONSIDERATIONS MECHANICAL CONSIDERATIONS ESTHETIC CONSIDERATIONS PONTIC FABRICATION REFERENCES

Definition Pontic 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 Requirements A 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 design The 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 assessment Certain procedures enhance the success of pontics

they are: pontic space residual ridge contour gingival architecture preservation

Classification of pontics Pontic 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 conical NO 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/HYGIE NIC SADDLE-RIDGELAP CONICAL

All metal Not recommended

Posterior mandible Not recommended

All metal Metal ceramic All resin

Molars without esthetic requirement High esthetic requirement

MODIFIED RIDGE- All metal LAP Metal ceramic All resin OVATE All metal Metal ceramic All resin

Very high esthetic requirement

PONTIC DESIGN SANITARY/HYGIENIC SADDLE-RIDGE-LAP CONICAL

ADVANTAGES Good access for oral hygiene esthetic Good access for oral hygiene Good esthetics Superior esthetics Negligible food entrapment Ease of cleaning

DISADVANTAGES Poor esthetics Not amenable to oral hygiene Poor esthetics

MODIFIED RIDGE-LAP OVATE

Moderately easy to clean Requires surgical preparation Not for residual ridge defects

PONTIC DESIGN SANITARY/HYGIENIC

INDICATIONS Non esthetic zones Impaired oral hygiene Not recommended Posterior areas where esthetic is minimal consideration

CONTRAINDICATIONS Where esthetics is essential Less vertical dimension Not recommended Poor oral hygiene

SADDLE-RIDGE-LAP CONICAL

MODIFIED RIDGE-LAPOVATE

Most areas with esthetic considerationDesire for optimal esthetics High smile line

Where minimal esthetic consideration existsUnwillingness for surgery Residual 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 ponticbiologic

esthetic

mechani cal

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 SYSTEMSMETALCERAMIC

ADVANTAGE S

DISADVANTA INDICATION CONTRAIND GES S ICATIONSDIFFICULT WHEN ABUTMENT IS NOT METALCERAMIC WEAKER THAN ALL METAL NONESTHETIC MOST SITUATIONS LONG SPANS WITH HIGH STRESS

ESTHETIC BIOCOMPATIBLE

ALL METAL

STRENGTH STRAIGHTFORW ARD PROCEDURE

MANDIBULAR MOLARS ESPECIALLY UNDER HIGH BITE FORCE AREAS OF HIGH ESTHETIC CONCERN

WHERE ESTHETICS IS IMPORTANT

FIBRE REINFORCED ALL RESIN

CONSIDERATIVE WHEN USED WITH INLAY PROCEDURE ESTHETICS EASE OF REPAIR

LIMITED TO SHORT SPANS

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.

REFERENCES ROSEN-STIEL SHILLINGBURG

THANK YOU


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