PONTIC DESIGN

CHAPTER 20 PG 513-541

BRIDGE
ABTUMENT : The tooth which support the bridge or part of the bridge and to which the retainer is cemented.

Retainer .
is that part of the bridge which is cemented to the abutment tooth
retainer

The pontic
Pontics are the artificial teeth in a fixed partial prosthesis, 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
Rigid connector

pontic

retainer

Functions of the pontic

1-mastication
the pontic provides hard surfaces against which food can be chewed by teeth in the opposing arch

2- Speech (phonetics) A space created by the loss of tooth alters the pattern of airflow making normal speech difficult. pontic helps to restrict air passage through edentulous area to aid in the reestablishment of normal sounds

3 -maintenance of tooth relationship

when missing teeth 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 and occlusally into open area.
.

Pontics maintain the integrity of dental arches by preventing teeth that are adjacent to and opposing an edentulous area from moving out of their relationship.

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

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

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.

Classification of residual ridges

1-Class I defects faciolingual loss of tissue width with normal height. 2-Class II defects loss of ridge height with normal ridge width. 3- Class III defects a combination of loss in both dimensions.

Pontic space
Preventing tilting or drifting of the adjacent teeth into the edentulous space is important function of the fixed partial denture (FPD).

TERMINOLGY
SPAN the part of the bridge which covers the edentulous area . Its connected or jointed to retainers at both ends in most of the bridges. but at one end in the case of cantilever bridges. .

Types of pontics

According to design

According to material All metal All ceramic

With Mucosal contact

Without Mucosal contact

Metal-combination Metal-ceramic metal-acrylic

Pontic Design:
Design is more important than the choice of the material. Proper design clean ability, tissue health & esthetics.

1- Pontics with mucosal contact

Divided to ; 1- saddle ridge- lap

2- modified ridge-lap

3- conical

4 - ovate

Saddle:

Modified ridge lap

*convex surface
*deflective contour *used in maxillary FPD

Conical

egg shaped

*Rounded, cleanable *will suited for use on thin Mandibular ridge.

Ovate

*Rounded end design *Tissue contact segment is set into a concavity. *created by Provisional FPD surgically *broad flat ridge

2-Without mucosal contact

Sanitary (hygienic)
Recommended Location
Posterior mandible

advantages

disadvantages

Good access for hygiene

Poor esthetics

modified sanitary pontic

A-sanitary/Hygienic
B-modified sanitary pontic

*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)
A

Pontic designs
Sanitary (hygienic)

Recommended Location
Posterior mandible

advantages
Good access for hygiene

disadvantages

form

Poor esthetics

saddle or ridge-lap
Modified ridge-lap

Not recommended
Anterior teeth and premolars , some maxillary molars

Esthetics Good esthetics

Not amenable to oral hygyeine

Moderately easy to clean

Conical Egg or heart shaped Ovate

Molars without esthetics requirements

Good access for oral hygiene

Poor esthetics

Maxillary incisor and premolars

Superior esthetics negligible food entrapment easy to clean

Requires surgical preparation

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

Connectors(JOINTS) For Fixed Partial Dentures

connectors are those parts of a fixed partial denture (FBD) that join retainers and pontics together

Types of Connectors
RIGID CONNECTORS
rigid connectors in metal can be made by: a- cast connectors: shaped in wax as apart of the process. b. Soldering connectors: use of intermediate metal alloy whose melting temperature is

lower than that of the parents metal. .

c . Welded connectors: melting adjacent surfaces with heat or pressure D- loop connectors Sometimes required when an existing diastema is to be maintained in a planned fixed prosthesis.

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.

PRINCIPLES CONNECTORS DESIGN

1-size Connectors must be sufficiently large to prevent distortion or fracture during function. but not too large to prevent interference with plaque, periodontal tissue disturbance over time. 2-shape The shape of the tissue surface of the connector should be curved faciolingually and highly polished and smooth to facilitate cleaning and patient should be satisfied with the appeareance.

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

SANITARY/HYGIE NIC SADDLE-RIDGELAP CONICAL

All metal

Posterior mandible

Not recommended

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-LAP
OVATE

Most areas with esthetic consideration

Desire for optimal esthetics High smile line

Where minimal esthetic consideration exists

Unwillingness for surgery Residual ridge defects

Considerations for successful pontic

biologic

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 SYSTEMS

METALCERAMIC

ADVANTAGE S

DISADVANT AGES
DIFFICULT WHEN ABUTMENT IS NOT METALCERAMIC WEAKER THAN ALL METAL NONESTHETIC

INDICATION S
MOST SITUATIONS

CONTRAINDI CATIONS
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 REINFORCE D ALL RESIN

CONSIDERATIVE WHEN USED WITH INLAY PROCEDURE ESTHETICS EASE OF REPAIR

LIMITED TO SHORT SPANS

LONG SPAN PARTIAL FIXED DENTAL PROSTHESIS