Pontics

Preeti kalia IInd year PG student Dept of Prosthodontics A.E.C.S Maaruti College of Dental Sciences

Pontics

Definition

Requirements Design Pretreatments assessment

Types

Fabrication

Definition
Pontic GPT : 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

Definition
Acc to Tylman pontic is the

suspended member of a fixed partial denture. it replaces the lost natural tooth, restores function ,and occupies the space of the missing tooth.

Ideal requirements of pontics

Smooth surfaced and convex in all directions Easily cleansable

Pinpoint pressure free contact on the ridge No irritation to the gingival tissues

Ideal requirement of pontics

Facilitate plaque control Emergence profile

Strength and longevity

Be esthetic

Ideal requirements of pontics

Restore function No abutment overloading

Color stable

Functions of pontics
Mastication Speech Esthetics

Considerations for a successful pontic design

Biologic considerations
Ridge contact Area of contact with ridge should be small and convex.

Oral hygiene considerations

Pontic materials

 Differences in the plaque-retaining capacities of.samples of a Type III gold, gold for veneering with porcelain, a vacuum-fired

bonded porcelain Veneer, and an acrylic resin.

After 48 hours in vivo, the Ceramco metal

and Type III gold specimens accumulated significantly more dark stains than acrylic ones

Wise. M et al and Dykema .R, The plaque-retaining capacity of four dental materials,J Proshtet 1975;33:178

Occlusal forces
Reduce buccolingual width 30%

to lessen occlusal forces 12% increase in chewing efficiency Pontics with normal occlusal widths in the occlusal third area

Mechanical considerations

Improper choice of materials Poor framework design Poor tooth preparation Poor occlusion

It can be seen that the maximum tensile stress at the solder joint, mesial to the second molar and above the gingiva, was reduced from2,400 p.s.i, in the conventional pontic to 1,200 p.s.i, in the sanitary pontic and finally to 720 p.s.i, in the modified sanitary pontic.

For the solder joint distal to the second

premolar, also above till gingiva, the reductions were in the order of 1,920 (C.P.)to 960 (S.P.) to 720 p.s.i. (M.S.P.).
Hood, J. A. Stress and deflection of three different pontic designs. J Prosthet Dent 33:54-59, 1975

Esthetic considerations

Incisogingival length
Root can be

stained to simulate exposed dentine. Pink porcelain to simulate the gingival tissues

Mesiodistal width

Space

discrepancy less problem in posteriors

Mesiodistal width
Orthodontic treatment Pontic of abnormal size-

illusion of natural tooth

Pretreatment assessment

Diagnostic cast

Wax up

Pontic space

Individual crowns of increased proximal contours were preferred to an FPD with undersized pontics

Residual ridge contour

Food entrapment

Loss of residual ridge contour leading to unesthetic open gingival embrasures

Residual ridge contour

Class I defect.

Class II defect.

Class III defect.

Sieberts classification

Residual ridge contour

Abrams et al showed Class I defects to constitute 32.4% Class II- 2.9% Class III- 55.9% 8.8% having no defects

Surgical management of class I defect

Pouch technique

Surgical management of class I defect

Pouch technique

Surgical management of class II and III defect

Interpostional graft

Surgical management of class II and III defect

onlay graft

Gingival architecture preservation

Classification
1. Depending on shape of surface

contacting the ridge(Tylmann)

Sanitary Modified sanitary Spheroidal Saddle Ridge lap Modified ridgelap Ovate

2.According to Rosenstiel depending on mucosal contact

A. mucosal contact

ridge lap modified ridge lap ovate conical B. No mucosal contact sanitary(hygenic) modified sanitary

3.According to the form(Johnston)

Sanitary or Hygenic Anatomic type

4.Based on materials used

Metal Metal and porcelain Metal and resin

5.Prefabricated pontics
Flat back Longpinfacing Trupontic

Pontips Reverse pin facings

Sanitary or hygienic

Modified sanitary pontic

Ridge lap pontic

Modified ridge lap pontic

Conical pontic

Ovate pontic

Modified ovate pontic

Contact more labially than ovate pontic Easier to clean No need of surgical augmentation Push the labial gingival margin away to floss

Liu.S,J Esthet Restor Dent 16:273-283, 2004

Residual ridge contour

To determine the frequency and the

nature of tissue reactions of underlying residual ridge mucosa to specific pontic designs, and To compare the frequency and the nature of tissue reactions of residual ridge mucosa to various materials used in pontic construction.
Stein.R.S , Pontic residual ridge relationship, J Proshtet Dent 1966;16: 251-285

Metal Ceramic pontics

Uniform veneer of porcelain- 1.2 mm Metal surface smooth and free of pits Round angles Occlusal centric contacts 1.5 mm away from junction

Metal ceramic pontics

wax the prosthesis

All ceramic pontics

Resin veneered pontics

Fiber reinforced composite resin pontics

Pontic fabrication
All metal hygienic pontic Metal ceramic pontic

Armamentarium

Sable brush Plaster bowl Spatula Quick setting plaster Bunsen burner PKT waxing instruments- No 1,2,3,4,5 Beavertail burnisher No 7 wax spatula Inlay casting wax Die lubricant Cotton pliers Hollow plastic sprue

All metal hygienic pontic fabrication

All metal hygienic pontic fabrication

All metal hygienic pontic fabrication

All metal hygienic pontic fabrication

All metal hygienic pontic fabrication

Metal ceramic pontics

Requirements
Adequate bulk of

metal Uniform thickness of porcelain Continuous strip of metal on lingual surface

Scalloped or trestle design

Connector is diminished in

faciolingual dimension Indication Bulk or rigidity in connector areas Tissue contact modified ridge lap

Metal ceramic pontics

To produce continuous contour and

uniform thickness of porcelain fabricate wax pattern to full contour and cut back Fabricate the copings No 7 wax spatula Blue inlay wax stick edentulous area

Metal ceramic pontics

Check the

alignment in a mesiodistal and the facial profile

Metal ceramic pontics

Metal ceramic pontics

Available pontic systems

Advantages Disadvantages Indications Contraindications

Metal ceramic
All metal

Esthetics Biocompatible

Difficult if abutment not metal ceramic

Most situations
Mandibular molars, under high bite force

Long span with high stress

Esthetics

Strength Non esthetic Straightforward procedure Conservative with inlays Esthetics Rarely used

Fibre reinforced all resin Facings

Limited to short Esthetics spans Rarely used Rarely used

Long span

Rarely used

Review of literature

Kumbulolu.O et al, A Different Pontic Design for Fiber-Reinforced Composite Bridgeworks: A Clinical Report, Eur J Dent. 2007 January; 1(1): 5053.

Review of literature

Kim.T.H.Yet al, Simulated tissue using unique pontic design, J Prosthet Dent 2009;102:205-210

References
Malone W.F.P., Koth D.L., Cavazos E.

: Tylmans theory of practice of fixed prosthodontics. 8 Ed., lshiyaku publications, 1993,357-370

Rosenstiel R.F., Land M.F., Fujimot J.:

Contemporary fixed prosthodontics. 4th Ed., Mosby Publications, 2007, 616-648

References
Shillingburg H.T., Hobo S., Whisett

L.D., Jacobi R., Brackett S.E. Fundamentals of fixed prosthodontics, 3 Ed., Quintessence Publication,2007,India ,485-506
Stein.R.S , Pontic residual ridge

relationship, J Proshtet Dent 1966;16: 251-285

References
Wise. M et al and Dykema .R, The

plaque-retaining capacity of four dental materials,J Proshtet 1975;33:178

Liu.S ,Use of a modified ovate pontic in

areas of ridge defects: A report of 2 cases, J Esthet Restor Dent 16:273283, 2004

References
Kumbulolu.O et al, A Different Pontic

Design for Fiber-Reinforced Composite Bridgeworks: A Clinical Report, Eur J Dent. 2007 January; 1(1): 5053. Kim.T.H.Yet al, Simulated tissue using unique pontic design, J Prosthet Dent 2009;102:205-210

References
R.Duane Douglas ,Pontic design FPDpontic wax up .ppt FPD.ppt