The Pontics in Fixed Restorations

7/27/2019 The Pontics in Fixed Restorations

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PONTIC DESIGN

CHAPTER 20PG 513-541


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BRIDGE

ABTUMENT :

The tooth which support the bridge or part

of the bridge and to which the retainer is

cemented.


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Retainer

.

is that part of the bridge which is

cemented to the abutment tooth

retainer


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The pontic

Pontics are the artificial teeth in a fixed partialprosthesis, that replace the lost natural teeth ,and

restore function and appearance. Its suspended

between cast abutment restorations ,and attached

to retainer by a rigid connectors

pontic retainer

Rigid connector


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Functions of the pontic

1-mastication

the pontic provides hard surfaces against whichfood can be chewed by teeth in the opposing arch


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2- Speech (phonetics)

A space created by the loss of tooth alters the patternof airflow making normal speech difficult.

pontic helps to restrict air passage through edentulous

area to aid in the reestablishment of normal sounds


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3-maintenance of tooth

relationship

when missingteeth are not replaced, the

teeth posterior to edentulous

areas can move forward from

their normal position , its also

possible for teeth anterior to

and opposing edentulous

spaces to drift distally andocclusally into open area.

.


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Pontics maintain the integrity

of dental arches by preventing teeth thatare adjacent to and opposing an

edentulous area

from moving out of theirrelationship.


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4-esthetics (appearance)

Dental esthetics affects personal appearance , the

presence of a full complement of teeth with a natural

appearance is important to an individual's self image

.

-Pontics , fill in the empty spaces that would be observed

during talking and smiling, provide support for lips and

cheeks to allow normal facial form.

Pontic space


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The requirements of a pontic

1- Provide esthetics and comfort

2- Restore function

3- Biologically acceptable

4- Permit effective oral hygiene

5- Preserve underlying residual mucosa


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RESIDUAL RIDGE CONTOUR

The edentulous edge's contour should

evaluated carefully. The ridge should be

smooth, regular and free of frenum

attachment.

Loss of residual contour may lead to

unaesthetic appearance and lead to food

impaction.


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Classification of residual ridges

faciolingual loss ofClass I defects-1

tissue width with normal height.

loss of ridge height withClass II defects-2

normal ridge width.

a combination of lossClass III defects-3

in both dimensions.


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Pontic space

Preventing tilting or drifting of the adjacent

teeth into the edentulous space is

important function of the fixed partial

denture (FPD).


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TERMINOLGY

the part of the bridge which coversSPAN

the edentulous area . Its connected or

jointed to retainers at both ends in most of

the bridges. but at one end in the case ofcantilever bridges.

.


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Types of pontics

Accordingto design According to material

All metal

All ceramic

Metal-combination

Metal-ceramic metal-acrylic

With

Mucosal contact

Without

Mucosal contact


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Pontic Design:

Design is more important than the

choice of the material.

Proper design clean ability,tissue health & esthetics.


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1- Pontics with mucosal contact

Divided to ;

1- saddle ridge- lap

2- modified ridge-lap


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3- conical

4 - ovate


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Saddle:


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Modified ridge lap

*convex surface

*deflective contour

*used in maxillary FPD


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Conical egg shaped

*Rounded,

cleanable

*will suited for use

on thin Mandibular

ridge.


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Ovate

*Rounded end design

*Tissue contact segment is set

into a concavity.*created by

Provisional FPD

surgically

*broad flat ridge


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2-Without mucosal contact

Sanitary

(hygienic)

disadvantages

advantages

Recommended

Location

Poor estheticsGood

access for

hygiene

Posteriormandible

modified sanitary pontic


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A-sanitary/Hygienic*No contact with the ridge.

*used in non appearance zone

(lower post)

*Occlusogingival thickness

*all convex configuration.

*contraindicated if minimum

vertical space(tissue

proliferation can occur)

B-modified sanitary pontic

A

B


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form

disadvantages

advantages

Recommended

Location

Pontic

designs

Poor esthetics

Good access

for hygiene

Posterior

mandible

Sanitary

(hygienic)

Not amenable to

oral hygyeine

Esthetics

Not

recommendedsaddle or

ridge-lap

Moderately easy toclean

Goodesthetics

Anterior teeth andpremolars , some

maxillary molars

Modifiedridge-lap

Poor esthetics

Good access

for oral

hygiene

Molars without

esthetics

requirements

Conical

Egg or heartshaped

Requires surgical

preparation

Superior

esthetics

negligible food

entrapment

easy to clean

Maxillary incisor

and premolarsOvate


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Pontic selection

Pontic selection depends primarily on

esthetic and oral hygiene.

In the anterior region where esthetic is a

concern the pontic should be well adapted

to the tissue to make it appear that

emerge from the gingiva

In the posteriors teeth conversely


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Connectors(JOINTS)

For Fixed Partial Dentures

connectors are those parts of a fixed partial denture

(FBD) that join retainers and pontics together


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Types of Connectors

RIGID CONNECTORS

rigid connectors in metal can be made by:

: shaped in wax as apart ofcast connectors-a

the process.: use of intermediateSoldering connectorsb.

metal alloy whose melting temperature is

lower than that of the parents metal..


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: melting adjacentc . Welded connectors

surfaces with heat or pressure

loop connectors-D

Sometimes required when an existing

diastema is to be maintained in a plannedfixed prosthesis.


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NON RIGID CONNECTORS

Is indicated when it is not possible to

prepare two abutment for an (FPD) with a

common path of placement. So

segmentally the design of large , complex(FBD); into shorter compartments is easier

to replace.


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PRINCIPLES CONNECTORS DESIGN

size-1Connectors must be sufficiently large to prevent

distortion or fracture during function. but not toolarge to prevent interference with plaque,

periodontal tissue disturbance over time.shape-2

The shape of the tissue surface of the connectorshould be curved faciolingually and highly

polished and smooth to facilitate cleaning andpatient should be satisfied with theappeareance.


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3-postion

The location of the contact area should be

established correctly to influence the

success and stability of the prosthesis.

In the anterior teeth

The connector should placed lingually

In the posterior teeth

Located in the occlusal third of the crown

and more lingually

PONTIC DESIGN MATERIALS LOCATION


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PONTIC DESIGN MATERIALS LOCATION

SANITARY/HYGIE

NIC

All metal Posterior mandible

SADDLE-RIDGE-

LAP

Not recommended Not recommended

CONICAL All metalMetal ceramic

All resin

Molars withoutesthetic

requirement

MODIFIED RIDGE-

LAP

All metal

Metal ceramicAll resin

High esthetic

requirement

OVATE All metal

Metal ceramic

All resin

Very high esthetic

requirement


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PONTIC DESIGN ADVANTAGES DISADVANTAGES

SANITARY/HYGIENIC Good access for oral

hygiene

Poor esthetics

SADDLE-RIDGE-LAP esthetic Not amenable to oral

hygiene

CONICAL Good access for oralhygiene

Poor esthetics

MODIFIED RIDGE-LAP Good esthetics Moderately easy to clean

OVATE Superior estheticsNegligible food

entrapment

Ease of cleaning

Requires surgicalpreparation

Not for residual ridge

defects


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PONTIC DESIGN INDICATIONS CONTRAINDICATIONS

SANITARY/HYGIENIC Non esthetic zones

Impaired oral hygiene

Where esthetics is

essential

Less vertical dimension

SADDLE-RIDGE-LAP Not recommended Not recommended

CONICAL 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

esthetics

High smile line

Unwillingness for surgery

Residual ridge defects


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Considerations for successful pontic

biologic

mechanicalesthetic


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BIOLOGIC:

Ridge contact

Oral hygiene considerationsPontic material

Occlusal forces


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Mechanical :

Available materials

Strong connectorsMetal ceramic framework

Rigidity


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Esthetic :

Incisogingival length

Mesiodistal widthGingival interface


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AVAILABLE

PONTIC

SYSTEMS

ADVANTAGE

S

DISADVANT

AGES

INDICATION

S

CONTRAINDI

CATIONS

METAL-

CERAMICESTHETIC

BIOCOMPATIBLE

DIFFICULT

WHEN

ABUTMENT IS

NOT METAL-

CERAMIC

WEAKER THAN

ALL METAL

MOST

SITUATIONS

LONG SPANS

WITH HIGH

STRESS

ALL METAL STRENGTH

STRAIGHTFORW

ARD

PROCEDURE

NONESTHETIC MANDIBULAR

MOLARS

ESPECIALLY

UNDER HIGH

BITE FORCE

WHERE

ESTHETICS IS

IMPORTANT

FIBREREINFORCE

D ALL RESIN

CONSIDERATIVE

WHEN USED

WITH INLAY

PROCEDURE

ESTHETICS

EASE OF

REPAIR

LIMITED TOSHORT SPANS

AREAS OF HIGHESTHETIC

CONCERN

LONG SPANPARTIAL FIXED

DENTAL

PROSTHESIS

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The Pontics in Fixed Restorations

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