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u Introduction
u Requirements of pontics
u Functions of pontics
u Pretreatment assessment
u Classification of deficient ridge contour
u Classification of pontics
u Pontic selection
u Optimal pontic design
u Basic principles of pontic design
u pontics fabrication
u Post insertion hygiene
u Conclusion
u references
 

u Jeaning of the word pontics-
pontics- ´PONSµ
u Jere replacement of tooth does not serve the purpose of
pontics
u Placing an exact anatomic replica is hygienically unmanageable
u The design is dictated by the factors
1. Esthetics
2. Function
3. Ease of cleansing
4. Jaintenance of healthy tissue
5. Patient comfort
º   

u 

 m mm  m



mm   m m m  mm 
    m m m     
  m
u 

          m



 mm   m   mm 
    m     m   
 
2       

1. Smooth surfaced and convex in all directions
2. Easily cleansable
3. Pinpoint pressure free contact on the ridge
4. No irritation to the gingival tissues
5. Facilitate plaque control
6. Emergence profile
7. Strength and longevity
8. Be esthetic
9. Restore function
10. No abutment overloading
11. Color stable


  

Jmm 

u provides resistance to opposing tooth when food is
chewed
u Helps in continuation of chewing

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u Space created by loss of tooth alters the airflow and
pontics restricts the airflow
G 
u Improves the personnel appearance
Jm  m    m  

tooth loss

teeth movement

occlusal interferences

excessive tooth mobility or


TJ disturbances
÷  m m  
u Tools of pretreatment assesment
1. Diagnostic casts
2. Diagnostic waxing
u  
 

u Jesiodistal and occluso cervical space


u Analysed for any drifting or tilting of teeth
u In case of reduced pontic space
1. Orthodontic repostioning
2. Small pontics(disadvantages)
3. Increase the proximal contours of adjacent teeth
4. No prosthodontic intervention
Õ    
  

Ideal ridge contour:


1. Should have smooth regular surface of attached
gingiva with adequate width and height for pontic
placement.
2. Free of frenal attachment and must sustain the
appearance of interdental papilla
3. Ideal ridge contour vary with the type of pontic to
be used
u For modified ridge lap
u For ovate pontic
ë   
  

u a ridge may be excessive due to excessive hard or


soft tissue
|m 
u In case of soft tissue excess-
excess-GINGIVOPLASTY
u incase of hard tissue excess-
excess-OSSEOUS
REDUCTION
º 
    
  

u Causes of deficient ridge


1.trauma during tooth extraction
2.Traumatic injury
3.Developmental defects
4.Advanced periodontal disease
u preventive measures
1.Proper exodontic procedures
2.Implantation of granular or root form synthetic grafts
3.Ridge augmentation
4.Early treatment of periodontal disease
! 
  
    
  

u Acc to SEIBERT
I ²buccolingual loss of tissue
with normal tissue height
II-
II-apicocoronal loss of tissue
with normal tissue width
III--combined loss of tisssue
III
in both dimensions
Ñ
u ALLEN modified this

classification and included

the severity of the defect
JILD ²less than 3mm
JODERATE--3-6mm
JODERATE
SEVERE--greater than 6 mm
SEVERE
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1. For class I defects
       
^

 22 

    mm mm


    

u ÷  to simulate the gingival contour of the


÷  
adjacent teeth
u ÷  
÷ 
u Abutment preparation before the extraction
u Indirectly fabricated provisional FPD

 
 
1. Depending on shape of surface contacting the
ridge(TYLJANN)
u sanitary
u Jodified sanitary
u Spheroidal
u Saddle
u Ridge lap
u Jodified ridgelap
u ovate
^ 

         


    

 
   
u Saddle
u Jodified saddle
u Ridgelap
u Jodified ridge lap
u Lap facing
u Spheroidal
u Jodified spheroidal
u Egg ,bullet or heart shaped
u Sanitary
u modified sanitary
u Bar shaped
u 

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

    %& '

sanitary or hygenic

anatomic type

5.Based on materials used


metal
metal and porcelain
metal andresin
[  
  

Flat back Trupontic

Longpinfacing

Pontips
Reverse pin facings
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u º  
Replaces all contours of a missing
toth
Concave contacting surface
Ridge lap
Emerence profile
Snug contact
u Ñ m m 
esthetics
u ºm m m 
difficult to clean
may cause tissue
inflammation
J    
u º 
Combined features of saddle
and hygenic pontics
Ridge lap ²modified
no concavity , FPD partially seated. $FPD seated

tissue contact resembles


letter ´Tµ
u Ñ m m 
Good esthetics
Possible to maintain
hygiene
u ºm m m 
hygiene is inferior to sanitary
u á  m
appearance zone
u ! m m 
where esthetics is least concerned
u Jm m
metal cermic and all resin
|  

º 
u No contact with residual ridge
u Occluso gingival thickness greater than 3mm
u Adequate space for cleansing
u Two configurations
1. Fish belly design
2. Perel pontic, arc shaped FPD, modified sanitary
pontic
Ñ m m 
u Good access for oral hygiene
u Least tissue inflammation
ºm m m 
u Poor aesthetics
á  m
u Non appearance zone
! m m 
u Appearance zone
u Less vertical dimension
Jm m
u All metal
!
 

u Synomyms
u Design
Gingival surface ²rounded and
small tip
Preferred with knife edged ridge
u Advantages
Oral hygiene
u Disadvantages
Poor esthetics
á  m
u Jolars with out esthetic requirement

! m m 
u Esthetic zone

u Patients with poor oral hygiene

Jm m
u Allmetal

Jetal--cermic
u Jetal

u All resin
  

u Jost esthetically appealing design


º 
u Convex tissue surface of pontic
resides with in the ridge
u Treatment planning
u Prepration of ridge during extraction
u Preparing the preexisting residual ridge
Ñ m m 
u Emergence profile

u Esthetics

u Stronger than modified ridge lap


m m m 
u surgical prepration
u meticulous oral hygiene

á  m
u Jaxillary incisors,cuspids and premolars

! m m
Patients unwillingness for surgery

Jm m
Jetal--ceramic
Jetal
All--resin
All
 
 

u á m 

u Incase of PFJ retainers,PFJ pontics are used


u In case of partial veneer retainers,prefabricated
facings are indicated
u In case of complete metal retainer,all metal pontic is
used
u  
u Jaxillary anterior segment-
segment-modified ridge lap is the
design of choice
u Jultiple missing teeth-
teeth-minimize the interproximal
embrassure
u Posterior segment
u Jaxillary
u Jandibular
 m  m   m     m
u Long span areas with reduced occlusaogingival height- height-
porcelain fracture

á     m    


u Extensive ridge resorption
u Tissue clearence of 3mm
u Ridge augmentation and recontouring`
  
 
ë

   
The pontic has to preserve the sorrounding
biological tissues
u á   m
1. Pressure free contact
2. Should be evaluated during try-
try-in stage
3. Contact should be on the keratinised attached
tissue
u m    m 
1. Toxins of microbial plaque
2. Gingival surface of pontic-
pontic-not accessible to bristles
of tooth brush
u ÷ m m
Pontic should have following qualities
1. Biocompatible--glazed porcelain,gold or metallic and acrylic
Biocompatible
2. Rigidity ² resist flexure during mastication
3. Strength ² metal ceramic junction
- in case of decresed vertical space for pontic
4 Longevity
5 Provide Good esthetic results
u m 
1 Reducing the buccolingual width by 30%
2 Problems with narrowing the occlusal table
3 Buccolingually collapsed ridges
J


   
u Causes of mechanical failure of an FPD
1. Poor tooth prepration
2. Improper choice of materials
3. Poor frame work design
4. Poor occlusion
u Long span FPD·s
1. Greater flexing
2. Displacement effects increase with cube of span
lenth
u Extension of ceramic on occlusal surfaces
u Available pontic materials
 $

 


1. Jetal ceramic pontics


u Commonley used
u Easy to keep clean and looks natural
limitations
u Chances of mechanical failure incase of inadequate frame work
design
-decreased ceramic thickness
-increased ceramic thickness
-cut back technique should be used to avoid discrepencies
u Jetal surfaces to be veneered should be smooth and free of
voids
u Sharp angles in the veneering area
u Jetal ceramic junction

* 

*
2. Resin veneered pontics
Advantages
u Easy to manipulate and repair

u Donot require high melting range

u Newer composite resin system(new generation


indirect resins)
1. Contains high density of ceramic fillers
2. High flexural strength
3. Jinimal polymerization shrinkage
4. Reduced wear rate
5. Improvements in bonding between metal and resin
disadvantages
Resistance to abrason
Susceptible to dimensional change
Discoloration due to leakage between metal-
metal-resin
interface
!  


   
u  

u Pontic simulation to natural


tooth is most challenging at
pontic tissue interface
u If original tooth contour is
followed,pontic looks
unnaturally long
incisogingivally
u Jodified ridge lap
u Ovate pontics

u Shadows around natural


tooth should be studied
u 2
   
u Height of tooth is more obvious
u Recontouring the gingival half of the labial surface

u In case of moderate to severe bone resorption,pontic can be made to


simulate a normal crown and portion of root
u J 
  ( 
u Space for tooth may be less or
more than the adjacent tooth
-orthodontic treatment
-incorporation of visual
perception principles to the pontic
u Width of the tooth is
identified by
1. Relative position of
mesiofascial and
distofascial line angles
2. Overall shape

3. Light reflection between


the line angles
u Space discrepency can be
compensated by altering the
shape of the proximal areas
ë 

  
 
u Occlusal surface:
surface: with in the
bounderies of the lines
connecting buccal and lingual
surfaces of abutment teeth
u Buccal ,lingual or palatal surfaces:
surfaces:
should lie in same plane as the
surfaces of adjacent teeth
u Angle of contact:
contact: junction of
pontic with gingivae should be as
wide as possible
u Area of contact:
contact: should be as
minimal as possible
u Jucosal contact:
contact: should be
either convex or flat
u Embrassures : should be as wide
as possible


  

u Anatomic contour waxing
u Prepare the pontic approximatley and adapt it to
ridge
u Pour molten wax into the impression of diagnostic
waxing or provisional restoration
u Prefabricated pontics

u Cut-back procedure
Cut-
u Jetal prepartion
u Porcelain application
    
u Embrasures-wide
Embrasures-
u Space between pontic
and tissue
u Education and
motivation of the patient
u Aids for maintaining the
hygiene
u Dental floss
u Interproximal brushes
u Pipe cleansers
u Evaluation of home care
   

u Stephen f rosenstiel: contemporary fixed prosthodontics.third edition
u Herbert t. shillinburg: Fundamentals of fixed prosthodontics.third
edition
u William f.p malone: tylman·s theory and practice of fixed
prosthodontics.eigth edition
u ohnston: modern practice in fixed prosthodontics.fourth edition
u Colin r. cowell: inlays crown and bridges.fourth edition
u Georgia k. johnson:ponic design and localised ridge augmentation in
fixed prosthodontics.DCNA1992,p.no591
p.no591--605
u Sohnmit singh: pontic designs.famdent practical dentistry
handbook 2002.p.no41-
2002.p.no41-46