Pontics in fpd


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Pontics in fpd

  1. 1. 1 INDIAN DENTAL ACADEMY Leader in continuing dental education www.indiandentalacademy.com www.indiandentalacademy.com
  2. 2. 22 The pontic, orartificial tooth, is the raisonThe pontic, orartificial tooth, is the raison d’etre of a fixed partial denture.d’etre of a fixed partial denture. Its name is derived from theIts name is derived from the LatinLatin ponspons, meaning bridge., meaning bridge. It is not a simple replacement, becauseIt is not a simple replacement, because placing an exact anatomic replica of the toothplacing an exact anatomic replica of the tooth in the space would be hygienicallyin the space would be hygienically unmanageable.unmanageable. The design of the prosthetic tooth will beThe design of the prosthetic tooth will be dictated by esthetics, function, ease ofdictated by esthetics, function, ease of cleaning, maintenance of healthy tissue on thecleaning, maintenance of healthy tissue on the edentulous ridge, and patient comfort.edentulous ridge, and patient comfort.www.indiandentalacademy.comwww.indiandentalacademy.com
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  5. 5. 55www.indiandentalacademy.comwww.indiandentalacademy.com
  6. 6. 66 REQUIREMENTREQUIREMENT Therequirementsof apontic areto:Therequirementsof apontic areto: 1.1. Restore function.Restore function. 2.2. Provide esthetics and comfort.Provide esthetics and comfort. 3.3. Be biologically acceptable.Be biologically acceptable. 4.4. Permit effective oral hygiene.Permit effective oral hygiene. 5.5. Preserve underlying residual mucosaPreserve underlying residual mucosa 6.6. Adequate strengthAdequate strength 7.7. ColourstabilityColourstability 8.8. Non irritantNon irritant 9.9. Do not overload the abutment toothDo not overload the abutment tooth Theserequirementsform thebasisfor thedesign ofTheserequirementsform thebasisfor thedesign of pontics.pontics. www.indiandentalacademy.comwww.indiandentalacademy.com
  7. 7. 77 PRINCIPLES OFPONTICPRINCIPLES OFPONTIC DESIGNDESIGN 1.1. CleansabilityCleansability 2.2. AppearanceAppearance 3.3. StrengthStrength www.indiandentalacademy.comwww.indiandentalacademy.com
  8. 8. 88 CLEANSABILITYCLEANSABILITY  All surfaces of the pontic,All surfaces of the pontic, especially " adjacent to theespecially " adjacent to the saddle, should be made assaddle, should be made as cleansable as possible.cleansable as possible.  They must be smooth andThey must be smooth and highly polished orglazed, nothighly polished orglazed, not contain any junctions betweencontain any junctions between materials.materials.  The embrasure space andThe embrasure space and connectors should be smoothconnectors should be smoothwww.indiandentalacademy.comwww.indiandentalacademy.com
  9. 9. 99 APPEARANCEAPPEARANCE  Where the full length of theWhere the full length of the pontic is visible, it must look aspontic is visible, it must look as tooth like as possible.tooth like as possible.  In premolarand first molarIn premolarand first molar region it is often possible toregion it is often possible to strike a happy compromisestrike a happy compromise between reasonablebetween reasonable appearances forthose parts ofappearances forthose parts of the pontic that are visible andthe pontic that are visible and good access forcleaning towardsgood access forcleaning towardswww.indiandentalacademy.comwww.indiandentalacademy.com
  10. 10. 1010 STRENGTHSTRENGTH  The longerthe span, theThe longerthe span, the greaterthe occlusal gingivalgreaterthe occlusal gingival thickness of the pontic shouldthickness of the pontic should be.be.  All pontics should beAll pontics should be designed to withstand occlusaldesigned to withstand occlusal forces; but porcelain pontics inforces; but porcelain pontics in the anteriorpart of the mouththe anteriorpart of the mouth may not of course be accepted tomay not of course be accepted towww.indiandentalacademy.comwww.indiandentalacademy.com
  11. 11. 1111 PRINCIPLEPRINCIPLE CONSIDERATIONSINCONSIDERATIONSIN PONTIC DESIGNINGPONTIC DESIGNING  Biological considerationBiological consideration  Esthetic considerationEsthetic consideration  Mechanical ConsiderationMechanical Consideration www.indiandentalacademy.comwww.indiandentalacademy.com
  12. 12. 1212 BIOLOGICALCONSIDERATIONBIOLOGICALCONSIDERATION  The biologic principles ofThe biologic principles of pontic design pertain to thepontic design pertain to the maintenance andmaintenance and preservation of the residualpreservation of the residual ridge, abutment and opposingridge, abutment and opposing teeth, and supporting tissue.teeth, and supporting tissue. www.indiandentalacademy.comwww.indiandentalacademy.com
  13. 13. 1313 RIDGE CONTACTRIDGE CONTACT  Pressure free contact between thePressure free contact between the pontic and the underlying tissues ispontic and the underlying tissues is indicated to prevent ulceration andindicated to prevent ulceration and inflammation of the soft tissues.inflammation of the soft tissues.  If any blanching of the soft tissueIf any blanching of the soft tissue is observed at try-in, the pressureis observed at try-in, the pressure area should be identified with aarea should be identified with a disclosing medium (i.e., pressure-disclosing medium (i.e., pressure- indicating paste) and the pontic reindicating paste) and the pontic re contoured until tissue contact iscontoured until tissue contact is entirely passive.entirely passive. www.indiandentalacademy.comwww.indiandentalacademy.com
  14. 14. 1414www.indiandentalacademy.comwww.indiandentalacademy.com
  15. 15. 1515  This passive contactThis passive contact should occurexclusively onshould occurexclusively on keratinized attached tissue.keratinized attached tissue.  When a pontic rests onWhen a pontic rests on mucosa, some ulcerationmucosa, some ulceration may appearas a result ofmay appearas a result of the normal movement ofthe normal movement of the mucosa in contact withthe mucosa in contact with the pontic.the pontic.www.indiandentalacademy.comwww.indiandentalacademy.com
  16. 16. 1616 ORAL HYGIENEORAL HYGIENE CONSIDERATIONSCONSIDERATIONS The chief cause of ridge irritationThe chief cause of ridge irritation is the toxins released from microbialis the toxins released from microbial plaque, which accumulate betweenplaque, which accumulate between the gingival surface of the ponticthe gingival surface of the pontic and the residual ridge, causingand the residual ridge, causing tissue inflammation and calculustissue inflammation and calculus formation.formation.  Patients must be taught efficientPatients must be taught efficient oral hygiene techniques, withoral hygiene techniques, with particularemphasis on cleaning theparticularemphasis on cleaning the gingival surface of the pontic.gingival surface of the pontic. www.indiandentalacademy.comwww.indiandentalacademy.com
  17. 17. 1717www.indiandentalacademy.comwww.indiandentalacademy.com
  18. 18. 1818www.indiandentalacademy.comwww.indiandentalacademy.com
  19. 19. 1919  Where tissue contact occurs,Where tissue contact occurs, the gingival surface of a ponticthe gingival surface of a pontic is inaccessible to the bristles of ais inaccessible to the bristles of a toothbrush. Therefore, excellenttoothbrush. Therefore, excellent hygiene habits must behygiene habits must be developed by the patient.developed by the patient.  Devices such as proxyDevices such as proxy brushes, pipe cleaners, superbrushes, pipe cleaners, super floss, and dental floss with afloss, and dental floss with a threaderare highlythreaderare highly recommended. www.indiandentalacademy.comwww.indiandentalacademy.com
  20. 20. 2020 PONTIC MATERIALPONTIC MATERIAL  Any material chosen to fabricateAny material chosen to fabricate the pontic should provide goodthe pontic should provide good esthetic results where needed;esthetic results where needed; biocompatibility, rigidity, andbiocompatibility, rigidity, and strength to withstand occlusalstrength to withstand occlusal forces; and longevity.forces; and longevity.  FPDs should be made as rigid asFPDs should be made as rigid as possible, because any flexurepossible, because any flexure during mastication orPara functionduring mastication orPara function may cause pressure on the gingivamay cause pressure on the gingivawww.indiandentalacademy.comwww.indiandentalacademy.com
  21. 21. 2121www.indiandentalacademy.comwww.indiandentalacademy.com
  22. 22. 2222  Metal ceramic pontics areMetal ceramic pontics are stifferand withstandstifferand withstand occlusal forces betterifocclusal forces betterif they are made fairly thickthey are made fairly thick and if the porcelain isand if the porcelain is carried right round themcarried right round them ,from the occlusal to the,from the occlusal to the ridge surface, leaving onlyridge surface, leaving only a line of metal visible ona line of metal visible on the lingual surface ornonethe lingual surface ornonewww.indiandentalacademy.comwww.indiandentalacademy.com
  23. 23. 2323  Occlusal contacts should notOcclusal contacts should not fall on the junction betweenfall on the junction between metal and porcelain duringmetal and porcelain during centric oreccentric toothcentric oreccentric tooth contacts, norshould a metalcontacts, norshould a metal ceramic junction occurin contactceramic junction occurin contact with the residual ridge on thewith the residual ridge on the gingival surface of the pontic.gingival surface of the pontic. www.indiandentalacademy.comwww.indiandentalacademy.com
  24. 24. 2424 OCCLUSAL FORCESOCCLUSAL FORCES  Potentially harmful forcesPotentially harmful forces are more likely to encounterare more likely to encounter if an FPDis loaded by anif an FPDis loaded by an accidental biting on a hardaccidental biting on a hard object orPara functionalobject orPara functional activities like bruxism ratheractivities like bruxism rather than by chewing food ofthan by chewing food of uniform consistency.uniform consistency.www.indiandentalacademy.comwww.indiandentalacademy.com
  25. 25. 2525  These forces are not reduced byThese forces are not reduced by narrowing the occlusal tablenarrowing the occlusal table  Narrowing the occlusal table mayNarrowing the occlusal table may impede oreven preclude theimpede oreven preclude the development of harmonious anddevelopment of harmonious and stable occlusal relationship.stable occlusal relationship.  Forthese reasons pontic withForthese reasons pontic with normal occlusal width of at least onnormal occlusal width of at least on the occlusal third are generallythe occlusal third are generally recommendedrecommendedwww.indiandentalacademy.comwww.indiandentalacademy.com
  26. 26. 2626 CONSIDERATIONSCONSIDERATIONS  Mechanical problems may beMechanical problems may be caused by improperchoice ofcaused by improperchoice of materials, poorframework design,materials, poorframework design, poortooth preparation, orpoorpoortooth preparation, orpoor occlusion.occlusion.  These factors can lead to fractureThese factors can lead to fracture of the prosthesis ordisplacement ofof the prosthesis ordisplacement of the retainers.the retainers.  Long-span posteriorFPDs areLong-span posteriorFPDs are particularly susceptible to mechanicalparticularly susceptible to mechanical problems.problems. www.indiandentalacademy.comwww.indiandentalacademy.com
  27. 27. 2727 Failure of a long span metalFailure of a long span metal ceramic FPDdue to highceramic FPDdue to high stressstress www.indiandentalacademy.comwww.indiandentalacademy.com
  28. 28. 2828  A strong all-metal ponticA strong all-metal pontic may be needed in high-stressmay be needed in high-stress situations ratherthan a metal-situations ratherthan a metal- ceramic pontic which would be moreceramic pontic which would be more susceptible to fracture.susceptible to fracture.  When metal ceramic pontics areWhen metal ceramic pontics are chosen, extending porcelain ontochosen, extending porcelain onto the occlusal surfaces to achievethe occlusal surfaces to achieve betteresthetics should also bebetteresthetics should also be carefully evaluated.carefully evaluated. www.indiandentalacademy.comwww.indiandentalacademy.com
  29. 29. 2929 AVAILABLE PONTICAVAILABLE PONTIC MATERIALSMATERIALS  Some fixed partial dentures areSome fixed partial dentures are fabricated entirely of metal,fabricated entirely of metal, porcelain, oracrylic resin, but mostporcelain, oracrylic resin, but most use a combination of metal anduse a combination of metal and porcelain.porcelain.  Acrylic resin veneered ponticsAcrylic resin veneered pontics have had limited acceptancehave had limited acceptance because of theirreduced durabilitybecause of theirreduced durability (wearand discoloration).(wearand discoloration).www.indiandentalacademy.comwww.indiandentalacademy.com
  30. 30. 3030  The newerindirectThe newerindirect composites, based on highcomposites, based on high inorganic-filled resins andinorganic-filled resins and the fiber-reinforcedthe fiber-reinforced materials used inmaterials used in composite resin and resin-composite resin and resin- veneered pontics.veneered pontics.www.indiandentalacademy.comwww.indiandentalacademy.com
  31. 31. 3131 Metal-ceramicMetal-ceramic PonticsPontics.. Most pontics are fabricated by the metal-ceramic technique. A well fabricated metal-A well fabricated metal- ceramicceramic pontic is strong, easypontic is strong, easy to keep clean,to keep clean, and looksand looks natural.natural. www.indiandentalacademy.comwww.indiandentalacademy.com
  32. 32. 3232 Resin veneeredResin veneered Pontics.Pontics. Historically acrylic resin-veneeredHistorically acrylic resin-veneered restorations had deficiencies thatrestorations had deficiencies that made them acceptable only asmade them acceptable only as longerterm provisionals.longerterm provisionals.  Theirresistance to abrasion wasTheirresistance to abrasion was lowerthan enamel orporcelain, andlowerthan enamel orporcelain, and noticeable wearoccurs with normalnoticeable wearoccurs with normal tooth brushing.tooth brushing. www.indiandentalacademy.comwww.indiandentalacademy.com
  33. 33. 3333 There are certain advantagesThere are certain advantages to using polymeric materials insteadto using polymeric materials instead of ceramics.of ceramics. – They are easy to manipulate andThey are easy to manipulate and repairand do not require the highrepairand do not require the high melting range alloys neededmelting range alloys needed forfor metal-ceramic techniques.metal-ceramic techniques. – New generation indirect resinNew generation indirect resin have a higherdensityhave a higherdensity ofof inorganic ceramic fillerthaninorganic ceramic fillerthan traditional direct and indirecttraditional direct and indirectwww.indiandentalacademy.comwww.indiandentalacademy.com
  34. 34. 3434 FIBER REINFORCEDFIBER REINFORCED COMPOSITE RESIN PONTICSCOMPOSITE RESIN PONTICS  Composite resin can beComposite resin can be used in FPDwithout a metalused in FPDwithout a metal substructuresubstructure  A substructure matrix ofA substructure matrix of impregnated glass orpolymerimpregnated glass orpolymer fiberprovides structuralfiberprovides structural strengthstrength.. www.indiandentalacademy.comwww.indiandentalacademy.com
  35. 35. 3535 ESTHETICESTHETIC CONSIDERATIONSCONSIDERATIONS No matterhow well biologic andNo matterhow well biologic and mechanical principles have beenmechanical principles have been followed during fabrication, the patientfollowed during fabrication, the patient will evaluate the result by how it looks,will evaluate the result by how it looks, especially when anteriorteeth haveespecially when anteriorteeth have been replaced.been replaced.  Many esthetic considerations thatMany esthetic considerations that pertain to single crowns also apply topertain to single crowns also apply to the pontic. Several problems unique tothe pontic. Several problems unique to the pontic may be encountered whenthe pontic may be encountered when attempting to achieve a naturalattempting to achieve a natural appearance.appearance. www.indiandentalacademy.comwww.indiandentalacademy.com
  36. 36. 3636 THE GINGIVALTHE GINGIVAL INTERFACEINTERFACE  An esthetically successfulAn esthetically successful pontic SHOULDreplicate thepontic SHOULDreplicate the form, contours, incisal edge,form, contours, incisal edge, gingival and incisal embrasures,gingival and incisal embrasures, and colorof adjacent teeth.and colorof adjacent teeth.  The pontics simulation of aThe pontics simulation of a natural tooth is most oftennatural tooth is most often betrayed at the tissue-ponticbetrayed at the tissue-pontic interface.interface. www.indiandentalacademy.comwww.indiandentalacademy.com
  37. 37. 3737  The greatest challenge here is toThe greatest challenge here is to compensate foranatomic changes thatcompensate foranatomic changes that occurafterextraction. Special attentionoccurafterextraction. Special attention should be paid to the contourof theshould be paid to the contourof the labial surface as it approaches thelabial surface as it approaches the pontic-tissue junction to achieve apontic-tissue junction to achieve a natural appearancenatural appearance  This cannot be accomplished by merelyThis cannot be accomplished by merely duplicating the facial contourof theduplicating the facial contourof the missing tooth, because aftera tooth ismissing tooth, because aftera tooth is removed, the alveolarbone undergoesremoved, the alveolarbone undergoes resorption and/orremodelingresorption and/orremodeling..www.indiandentalacademy.comwww.indiandentalacademy.com
  38. 38. 3838  If the pontic is poorlyIf the pontic is poorly adapted to the residual ridge,adapted to the residual ridge, there will be an un naturalthere will be an un natural shadow in the cervical area butshadow in the cervical area but looks odd and spoils thelooks odd and spoils the illusion of the natural tooth.illusion of the natural tooth.  Additional recesses acquiringAdditional recesses acquiring at the gingival interface willat the gingival interface will collect food debris furthercollect food debris further betraying the illusion of thebetraying the illusion of thewww.indiandentalacademy.comwww.indiandentalacademy.com
  39. 39. 3939 SPECFICATIONS FOR PONTICSPECFICATIONS FOR PONTIC DESIGN:DESIGN: ANTERIOR PONTIC DESIGNANTERIOR PONTIC DESIGN  All surfaces should beAll surfaces should be smooth and convex andsmooth and convex and properly finishedproperly finished  Contact with the labialContact with the labial mucosa should be minimal andmucosa should be minimal and pressure freepressure free  Esthetics may require a longEsthetics may require a long area of contact to prevent thearea of contact to prevent thewww.indiandentalacademy.comwww.indiandentalacademy.com
  40. 40. 4040 POSTERIOR PONTICPOSTERIOR PONTIC DESIGNDESIGN All surfaces should be convex andAll surfaces should be convex and properly finishproperly finish  Contact with buccal contagious slopeContact with buccal contagious slope should be minimal and pressure freeshould be minimal and pressure free  Buccal and lingual shunting mechanismBuccal and lingual shunting mechanism should confirm to that of adjacent teethshould confirm to that of adjacent teeth  The occlusal table must be in functionalThe occlusal table must be in functional harmony with the occlusion of all theharmony with the occlusion of all the teeth.teeth.  The overall length of the buccal surfaceThe overall length of the buccal surface should be equal to that of the adjacentshould be equal to that of the adjacent abutment teethabutment teeth www.indiandentalacademy.comwww.indiandentalacademy.com
  41. 41. 4141 CCLLAASSSSIIFFIICCAATTIIOO NN OOFF PONTICPONTIC S www.indiandentalacademy.comwww.indiandentalacademy.com
  42. 42. 4242 II BASED ON RELATIONBASED ON RELATION TOTO SOFT TISSUESSOFT TISSUES A -A -Mucosal contactMucosal contact – ridge lap/saddleridge lap/saddle – modified ridge lapmodified ridge lap – ovateovate – conicalconical B-B- No Mucosal contactNo Mucosal contact  sanitary (hygienic)sanitary (hygienic)  modified sanitary(hygienic)modified sanitary(hygienic) www.indiandentalacademy.comwww.indiandentalacademy.com
  43. 43. 4343 IIII BASED ON MATERIALSBASED ON MATERIALS USEDUSED A -A - MetallicMetallic – Gold alloysGold alloys – Nickel chromium alloyNickel chromium alloy B -B - Non MetallicNon Metallic  AcrylicAcrylic  PorcelainPorcelain C -C - CombinationCombination-alloys with acrylic or-alloys with acrylic or porcelainporcelain www.indiandentalacademy.comwww.indiandentalacademy.com
  44. 44. 4444 IIIIII PRE FABRICATEDPRE FABRICATED PONTICSPONTICS  TruponticTrupontic  Interchangeable facingInterchangeable facing  Pin facingPin facing  Modified pin facingModified pin facing  Reverse pin facingReverse pin facing  Harmony facingHarmony facing  Porcelain fused to metalPorcelain fused to metalwww.indiandentalacademy.comwww.indiandentalacademy.com
  45. 45. 4545 IVIV BASED ON TYPE OFBASED ON TYPE OF RETENTION USED FORRETENTION USED FOR FACINGFACING  Pins, rails, post and coresPins, rails, post and cores  Bonded to metal – in caseBonded to metal – in case of porcelainof porcelain  Mechanical inter locking –Mechanical inter locking – under cut –acrylicunder cut –acrylic www.indiandentalacademy.comwww.indiandentalacademy.com
  47. 47. 4747 PONTIC SPACEPONTIC SPACE  One function of an FPDis toOne function of an FPDis to prevent tilting ordrifting ofprevent tilting ordrifting of the adjacent teeth into thethe adjacent teeth into the edentulous space.edentulous space.  If such movement has alreadyIf such movement has already occurred, the space availableoccurred, the space available forthe pontic may be reducedforthe pontic may be reduced and its fabricationand its fabricationwww.indiandentalacademy.comwww.indiandentalacademy.com
  48. 48. 4848  At this point, creating anAt this point, creating an acceptable appearance withoutacceptable appearance without orthodontic repositioning of theorthodontic repositioning of the abutment teeth is oftenabutment teeth is often impossible particularly if estheticimpossible particularly if esthetic is important.is important.  When orthodontic repositioningWhen orthodontic repositioning is not possible, increasing theis not possible, increasing the proximal contours of theproximal contours of the adjacent teeth may be betteradjacent teeth may be betterwww.indiandentalacademy.comwww.indiandentalacademy.com
  49. 49. 4949 TISSUE CONTACTTISSUE CONTACT  The extent and shape of the ponticThe extent and shape of the pontic contact with the ridge is verycontact with the ridge is very important.important.  Excessive tissue contact has beenExcessive tissue contact has been cited as a majorfactorin the failurecited as a majorfactorin the failure of fixed partial dentures.of fixed partial dentures.  The area of contact between theThe area of contact between the pontic and the ridge should be smallpontic and the ridge should be small and the portion of the ponticand the portion of the pontic touching the ridge should be astouching the ridge should be as convex as possible.convex as possible. www.indiandentalacademy.comwww.indiandentalacademy.com
  50. 50. 5050www.indiandentalacademy.comwww.indiandentalacademy.com
  51. 51. 5151  If there is contact along theIf there is contact along the gingivofacial angle of the pontic,gingivofacial angle of the pontic, there must be no space betweenthere must be no space between pontic and soft tissue on thepontic and soft tissue on the facial side of the ridge.facial side of the ridge.  If the tip of the pontic extendsIf the tip of the pontic extends past the mucogingival junction,past the mucogingival junction, an ulcerwill form there.an ulcerwill form there.  The pontic should contact onlyThe pontic should contact only attached keratinized gingivaattached keratinized gingivawww.indiandentalacademy.comwww.indiandentalacademy.com
  52. 52. 5252 Post insertion HygienePost insertion Hygiene  Mesial distal and lingual gingivalMesial distal and lingual gingival embrasure of the pontic should beembrasure of the pontic should be wide open to allow the patient easywide open to allow the patient easy access forcleaningaccess forcleaning  The contact between the pontic andThe contact between the pontic and tissue must allow the passage oftissue must allow the passage of floss from one retainerto the otherfloss from one retainerto the other  Good hygiene around and undertheGood hygiene around and underthe pontic with dental floss,pontic with dental floss, interproximal brushes orpipeinterproximal brushes orpipewww.indiandentalacademy.comwww.indiandentalacademy.com
  53. 53. 5353 Even the smoothest ponticEven the smoothest pontic surface must be cleaned wellsurface must be cleaned well and often to prevent theand often to prevent the accumulation of plaque.accumulation of plaque. If cleaning is not done atIf cleaning is not done at frequent, regularintervals, thefrequent, regularintervals, the tissue around the pontic willtissue around the pontic will become inflamed.become inflamed.www.indiandentalacademy.comwww.indiandentalacademy.com
  54. 54. 5454  Pontics designed forplacement in thePontics designed forplacement in the appearance zone (areas of highappearance zone (areas of high visibility) must produce illusion ofvisibility) must produce illusion of being teeth, esthetically, withoutbeing teeth, esthetically, without compromising cleaning ability.compromising cleaning ability.  Those pontics placed in theThose pontics placed in the nonappearance zone (usuallynonappearance zone (usually mandibularposteriorreplacements)mandibularposteriorreplacements) are there to restore function andare there to restore function and prevent the drifting of teeth.prevent the drifting of teeth. www.indiandentalacademy.comwww.indiandentalacademy.com
  55. 55. 5555 DESIGDESIG NN Success of the FPDSuccess of the FPD depends on the ponticdepends on the pontic design.design. www.indiandentalacademy.comwww.indiandentalacademy.com
  56. 56. 5656  According to Eissmann, theAccording to Eissmann, the boundaries of the edentulous spaceboundaries of the edentulous space are the residual ridge, the opposingare the residual ridge, the opposing occlusal surface, the proximalocclusal surface, the proximal surfaces of the abutment teeth, andsurfaces of the abutment teeth, and the musculature of the tongue andthe musculature of the tongue and cheek orlips.cheek orlips.  The design consists of constructingThe design consists of constructing a substitute tooth that favorablya substitute tooth that favorably compares in form, function, andcompares in form, function, andwww.indiandentalacademy.comwww.indiandentalacademy.com
  57. 57. 5757 Pontic DesignsPontic Designs There are several designs available forThere are several designs available for useuse in situations requiringin situations requiring pontics inpontics in the fabrication ofthe fabrication of FPDs.They are:FPDs.They are: Hygienic,Hygienic, Saddle (Ridge Lap),Saddle (Ridge Lap), Modified Ridge Lap,Modified Ridge Lap, Conical,Conical, Ovate,Ovate, Prefabricated Pontic Facings, &Prefabricated Pontic Facings, &www.indiandentalacademy.comwww.indiandentalacademy.com
  58. 58. 5858 SanitarySanitary oror Hygienic PonticHygienic Pontic  The term hygienic is used toThe term hygienic is used to describe pontics that have nodescribe pontics that have no contact with the edentulouscontact with the edentulous ridge.ridge.  As its name implies, theAs its name implies, the primary design feature of theprimary design feature of the sanitary pontic allows easysanitary pontic allows easy cleaning, because its tissuecleaning, because its tissue surface remains clearof thesurface remains clearof the residual ridgeresidual ridge.. www.indiandentalacademy.comwww.indiandentalacademy.com
  59. 59. 5959www.indiandentalacademy.comwww.indiandentalacademy.com
  60. 60. 6060  This pontic design is frequentlyThis pontic design is frequently called a "sanitary pontic," which incalled a "sanitary pontic," which in years past was the trade name foryears past was the trade name for a prefabricated, convex facinga prefabricated, convex facing with’ a slot back, used forwith’ a slot back, used for mandibularmolarpontics 'mandibularmolarpontics '  This hygienic design permits easierThis hygienic design permits easier plaque control by allowing gauzeplaque control by allowing gauze strips and othercleaning devicesstrips and othercleaning devices to be passed underthe pontic andto be passed underthe pontic and seesawed in shoe-shine fashion.seesawed in shoe-shine fashion. www.indiandentalacademy.comwww.indiandentalacademy.com
  61. 61. 6161  The hygienic pontic is used inThe hygienic pontic is used in the nonappearance zone,the nonappearance zone, particularly forreplacingparticularly forreplacing mandibularfirst molars. Itmandibularfirst molars. It restores occlusal function andrestores occlusal function and stabilizes adjacent andstabilizes adjacent and opposing teeth. If there is noopposing teeth. If there is no requirement foresthetics, itrequirement foresthetics, it can be made entirely ofcan be made entirely ofwww.indiandentalacademy.comwww.indiandentalacademy.com
  62. 62. 6262  The occlusogingival thicknessThe occlusogingival thickness of the pontic should be noof the pontic should be no less than 3.0 mm. and thereless than 3.0 mm. and there should be adequate spaceshould be adequate space underit to facilitate cleaning.underit to facilitate cleaning. The hygienic pontic isThe hygienic pontic is frequently made overall-frequently made overall- convex configuration,convex configuration, faciolingually andfaciolingually and mesiodistallymesiodistally www.indiandentalacademy.comwww.indiandentalacademy.com
  63. 63. 6363  Making the undersurface of theMaking the undersurface of the pontic round without anglespontic round without angles allows foreasierflossing. It isallows foreasierflossing. It is more difficult to get floss tomore difficult to get floss to pass overa flat undersurfacepass overa flat undersurface evenly, orto get oversharpevenly, orto get oversharp faciogingival and linguogingivalfaciogingival and linguogingival line angles. The round designline angles. The round design has been described as a “has been described as a “fishfish bellybelly".". www.indiandentalacademy.comwww.indiandentalacademy.com
  64. 64. 6464www.indiandentalacademy.comwww.indiandentalacademy.com
  65. 65. 6565  ItsIts disadvantagesdisadvantages includeinclude entrapment of food particles,entrapment of food particles, which may lead to tongue habitswhich may lead to tongue habits that may annoy the patient.that may annoy the patient.  The hygienic pontic is theThe hygienic pontic is the least "tooth like" design and isleast "tooth like" design and is therefore reserved forteeththerefore reserved forteeth seldom displayed during functionseldom displayed during function (i.e., the mandibularmolars).(i.e., the mandibularmolars). www.indiandentalacademy.comwww.indiandentalacademy.com
  66. 66. 6666  An alternative design, in which theAn alternative design, in which the pontic is made in the form of a concavepontic is made in the form of a concave archway mesiodistally. Thearchway mesiodistally. The undersurface of the pontic is convexundersurface of the pontic is convex faciolingually, giving the tissue-facingfaciolingually, giving the tissue-facing surface of the pontic the configuration ofsurface of the pontic the configuration of a hyperbolic paraboloid.a hyperbolic paraboloid.  There is added bulk forstrength in theThere is added bulk forstrength in the connectors, and access forcleaning isconnectors, and access forcleaning is good. An esthetic version of this ponticgood. An esthetic version of this pontic can be created by veneering withcan be created by veneering with porcelain those parts of the pontic thatporcelain those parts of the pontic thatwww.indiandentalacademy.comwww.indiandentalacademy.com
  67. 67. 6767www.indiandentalacademy.comwww.indiandentalacademy.com
  68. 68. 6868  This design has beenThis design has been called an “arc-fixedcalled an “arc-fixed partial denture”partial denture” a "modified sanitarya "modified sanitary pontic”, orsimply apontic”, orsimply a ““Perel pontic”.Perel pontic”. www.indiandentalacademy.comwww.indiandentalacademy.com
  69. 69. 6969 SADDLE OR RIDGE LAPSADDLE OR RIDGE LAP PONTICPONTIC  This pontic looks mostThis pontic looks most like a tooth, replacinglike a tooth, replacing all the contours of theall the contours of the missing tooth.missing tooth.  It forms a largeIt forms a large concave contact with theconcave contact with the ridge, obliterating theridge, obliterating the facial, lingual, andfacial, lingual, and proximal embrasures.proximal embrasures. www.indiandentalacademy.comwww.indiandentalacademy.com
  70. 70. 7070  It is also called a ridge lap,It is also called a ridge lap, because it overlaps the facialbecause it overlaps the facial and lingual aspects of theand lingual aspects of the ridge.ridge.  A contact with the ridge thatA contact with the ridge that extends beyond the midline ofextends beyond the midline of the edentulous ridge, orathe edentulous ridge, ora sharp angle at thesharp angle at the linguogingival aspect of thelinguogingival aspect of the tissue contact, constitutes atissue contact, constitutes a ridge lapridge lap www.indiandentalacademy.comwww.indiandentalacademy.com
  71. 71. 7171  This design has long beenThis design has long been recognized as being uncleanrecognized as being unclean and uncleanable and it stilland uncleanable and it still is.is.  The saddle causes tissueThe saddle causes tissue inflammation, and it shouldinflammation, and it should not be used.not be used.  This design deficiency hasThis design deficiency has been shown to result inbeen shown to result inwww.indiandentalacademy.comwww.indiandentalacademy.com
  72. 72. 7272  CC A B C D www.indiandentalacademy.comwww.indiandentalacademy.com
  73. 73. 7373 MODIFIED RIDGE LAPMODIFIED RIDGE LAP PONTICPONTIC  The modified ridge lap ponticThe modified ridge lap pontic combines the best features ofcombines the best features of the hygienic and saddle ponticthe hygienic and saddle pontic designs, combining estheticsdesigns, combining esthetics with easy cleaning.with easy cleaning.  This design gives theThis design gives the illusion of a tooth, but itillusion of a tooth, but it possesses all ornearly allpossesses all ornearly all convex surfaces forease ofconvex surfaces forease of cleaningcleaning www.indiandentalacademy.comwww.indiandentalacademy.com
  74. 74. 7474 FPD partially seated FPD completely seated A :max, B:mand www.indiandentalacademy.comwww.indiandentalacademy.com
  75. 75. 7575  The lingual surface shouldThe lingual surface should have a slight deflective contourhave a slight deflective contour to prevent food impaction andto prevent food impaction and minimize plaque accumulation.minimize plaque accumulation.  There may be a slight facio-There may be a slight facio- lingual concavity on the faciallingual concavity on the facial side of the ridge, which can beside of the ridge, which can be cleaned and tolerated by thecleaned and tolerated by the tissue as long as the tissuetissue as long as the tissue contact is narrow mesiodistallycontact is narrow mesiodistallywww.indiandentalacademy.comwww.indiandentalacademy.com
  76. 76. 7676  Ridge contact must extendRidge contact must extend no fartherlingually than theno fartherlingually than the midline of the edentulousmidline of the edentulous ridge, even on posteriorteeth.ridge, even on posteriorteeth.  The contourof the-tissue-The contourof the-tissue- contacting area of the ponticcontacting area of the pontic should be convex, even if ashould be convex, even if a small amount of soft tissue onsmall amount of soft tissue on the ridge must be surgicallythe ridge must be surgically removed to facilitate it.removed to facilitate it. www.indiandentalacademy.comwww.indiandentalacademy.com
  77. 77. 7777 Tissue contact should resembleTissue contact should resemble a lettera letter TTwhose vertical armwhose vertical arm ends at the crest of the ridge.ends at the crest of the ridge. This design wasThis design was historically referred to as ridge-historically referred to as ridge- lap; the term ridge-lap is nowlap; the term ridge-lap is now used synonymously with theused synonymously with the saddle design.saddle design. The modified ridge lapThe modified ridge lap design is the most commondesign is the most common pontic form used in areas ofpontic form used in areas of the mouth that are visiblethe mouth that are visible during functionduring function.. www.indiandentalacademy.comwww.indiandentalacademy.com
  78. 78. 7878  This design, with aThis design, with a porcelain veneer, is theporcelain veneer, is the most commonly usedmost commonly used pontic design in thepontic design in the appearance zone forappearance zone for both maxillary andboth maxillary and mandibularfixed partialmandibularfixed partial denturesdentures www.indiandentalacademy.comwww.indiandentalacademy.com
  79. 79. 7979 CONICAL PONTICCONICAL PONTIC  Often ,called egg-shaped,Often ,called egg-shaped, bullet-shaped, orheart-shaped,bullet-shaped, orheart-shaped, the conical pontic is easy forthethe conical pontic is easy forthe patient to keep it clean.patient to keep it clean.  This pontic is related to theThis pontic is related to the "sanitary dummy" described by"sanitary dummy" described by Tinkerin 1918.Tinkerin 1918. Its use isIts use is limited to replacement of teethlimited to replacement of teeth overthin ridges in theoverthin ridges in the nonappearance zone.nonappearance zone.www.indiandentalacademy.comwww.indiandentalacademy.com
  80. 80. 8080www.indiandentalacademy.comwww.indiandentalacademy.com
  81. 81. 8181  It should be made asIt should be made as convex as possible with onlyconvex as possible with only one point of contact at theone point of contact at the centerof the residual ridge.centerof the residual ridge.  The conical pontic isThe conical pontic is rounded and cleanable, butrounded and cleanable, but the tip is small in relation tothe tip is small in relation to the overall size of the pontic.the overall size of the pontic. It is well suited foruse on aIt is well suited foruse on a thin mandibularridge.thin mandibularridge.www.indiandentalacademy.comwww.indiandentalacademy.com
  82. 82. 8282  When used with a broad, flatWhen used with a broad, flat ridge, the resulting largeridge, the resulting large triangularembrasure spacestriangularembrasure spaces around the tissue contact have aaround the tissue contact have a tendency to collect debris.tendency to collect debris.  This type of design may beThis type of design may be unsuitable forbroad residualunsuitable forbroad residual ridges, because the emergenceridges, because the emergence profile associated with the smallprofile associated with the small tissue contact point may createtissue contact point may create areas of food entrapment.areas of food entrapment.www.indiandentalacademy.comwww.indiandentalacademy.com
  83. 83. 8383 A: correctly with a thin ridge B:incorrectly with broad flat ridge www.indiandentalacademy.comwww.indiandentalacademy.com
  84. 84. 8484 OVATE PONTICOVATE PONTIC  The ovate pontic is a round-endThe ovate pontic is a round-end design currently in use wheredesign currently in use where esthetics is a primary concern.esthetics is a primary concern.  Its antecedent was theIts antecedent was the porcelain root-tipped pontic,porcelain root-tipped pontic, which was used considerablywhich was used considerably before 1930-as an esthetic andbefore 1930-as an esthetic and sanitary substitute forthesanitary substitute forthe saddle pontic. www.indiandentalacademy.comwww.indiandentalacademy.com
  85. 85. 8585 FPD partially seated FPD completely seatedwww.indiandentalacademy.comwww.indiandentalacademy.com
  86. 86. 8686  The ovate pontic is the mostThe ovate pontic is the most esthetically appealing ponticesthetically appealing pontic design. Its convex tissue surfacedesign. Its convex tissue surface resides in a soft tissue depressionresides in a soft tissue depression orhollow in the residual ridge,orhollow in the residual ridge, which makes it appearthat a toothwhich makes it appearthat a tooth is literally emerging from theis literally emerging from the gingiva.gingiva.  The tissue-contacting segmentThe tissue-contacting segment of the ovate pontic is bluntlyof the ovate pontic is bluntly rounded, and it is set into a www.indiandentalacademy.comwww.indiandentalacademy.com
  87. 87. 8787  The concavity can beThe concavity can be created by placement ofcreated by placement of a provisional fixeda provisional fixed partial denture with thepartial denture with the pontic extending one-pontic extending one- quarterof the way intoquarterof the way into the socket immediatelythe socket immediately afterextraction of theafterextraction of the tooth.tooth. www.indiandentalacademy.comwww.indiandentalacademy.com
  88. 88. 8888 The ovate ponticsThe ovate pontics AdvantageAdvantage includes its pleasingincludes its pleasing appearance and its strength.appearance and its strength.  It is easily flossed.It is easily flossed.  In addition, its recessed formIn addition, its recessed form is not susceptible to foodis not susceptible to food impaction.impaction.  The broad convex geometry isThe broad convex geometry is strongerthan that of thestrongerthan that of the modified ridge lap pontic.modified ridge lap pontic.www.indiandentalacademy.comwww.indiandentalacademy.com
  89. 89. 8989 DisadvantagesDisadvantages  Because the tissue surface ofBecause the tissue surface of the pontic is convex in allthe pontic is convex in all dimensions, it is accessible todimensions, it is accessible to dental floss; however, meticulousdental floss; however, meticulous oral hygiene is necessary tooral hygiene is necessary to prevent tissue inflammationprevent tissue inflammation resulting from the large area ofresulting from the large area of tissue contact.tissue contact.  Otherdisadvantage include theOtherdisadvantage include the need forsurgical tissueneed forsurgical tissuewww.indiandentalacademy.comwww.indiandentalacademy.com
  90. 90. 9090 Prefabricated PonticPrefabricated Pontic FacingsFacings At one time, preformedAt one time, preformed porcelain facings wereporcelain facings were popularforfabricatingpopularforfabricating pontics.pontics.  They required adaptationThey required adaptation to a specific edentulousto a specific edentulous space, afterwhich theyspace, afterwhich they were reglazed.were reglazed.www.indiandentalacademy.comwww.indiandentalacademy.com
  91. 91. 9191 Slot back Reversepin facing Harmony pin facing Tru- pontic Pontipwww.indiandentalacademy.comwww.indiandentalacademy.com
  92. 92. 9292  Some, such as Trupontics,Some, such as Trupontics, Sanitary pontics, and SteelesSanitary pontics, and Steeles facings, relied on a lug in afacings, relied on a lug in a custom cast metal backing tocustom cast metal backing to engage a slot in the occlusalengage a slot in the occlusal orlingual surface of theorlingual surface of the facingfacing  The large bulk of porcelainThe large bulk of porcelain could result in a thin goldcould result in a thin goldwww.indiandentalacademy.comwww.indiandentalacademy.com
  93. 93. 9393  Harmony and TrubyteHarmony and Trubyte facings used horizontalfacings used horizontal pins that fit into the goldpins that fit into the gold backing.backing.  They were difficult to useThey were difficult to use in limited occlusogingivalin limited occlusogingival space, and refitting thespace, and refitting the pins into a backing afterpins into a backing after casting was demanding.casting was demanding.www.indiandentalacademy.comwww.indiandentalacademy.com
  94. 94. 9494  Porcelain denture teeth alsoPorcelain denture teeth also were modified to use as ponticwere modified to use as pontic facings. Multiple pin holes, 2.0 mmfacings. Multiple pin holes, 2.0 mm deep, were made with a drill pressdeep, were made with a drill press in the lingual surface of the reversein the lingual surface of the reverse pin facing. The pins came out of thepin facing. The pins came out of the backing, providing retention wherebacking, providing retention where a deep overbite would have overa deep overbite would have over shortened conventional pins.shortened conventional pins.  Unfortunately, the pin holes in theUnfortunately, the pin holes in the facing were stress points that led tofacing were stress points that led to fracture.fracture. www.indiandentalacademy.comwww.indiandentalacademy.com
  95. 95. 9595 PREFABRICATEDWAX PONTIC www.indiandentalacademy.comwww.indiandentalacademy.com
  96. 96. 9696 Metal-CeramicMetal-Ceramic PonticsPontics Most pontics are fabricated by theMost pontics are fabricated by the metal-ceramic technique.metal-ceramic technique.  With the widespread use ofWith the widespread use of metal-ceramic restorations, metal-metal-ceramic restorations, metal- ceramic pontics have replaced otherceramic pontics have replaced other types of pontics employingtypes of pontics employing porcelain.porcelain. Metal-ceramic pontics have theMetal-ceramic pontics have the greatest esthetic potential asgreatest esthetic potential as prosthetic replacements formissingprosthetic replacements formissing www.indiandentalacademy.comwww.indiandentalacademy.com
  97. 97. 9797  A well fabricated metal-A well fabricated metal- ceramic pontic is strong,ceramic pontic is strong, easy to keep clean, andeasy to keep clean, and looks natural.looks natural.  Additionally, metal-ceramicAdditionally, metal-ceramic pontics are stronger, sincepontics are stronger, since the porcelain is bonded tothe porcelain is bonded to the metal substrate ratherthe metal substrate rather than cemented to it.than cemented to it.www.indiandentalacademy.comwww.indiandentalacademy.com
  98. 98. 9898  Excessive thickness of porcelainExcessive thickness of porcelain contributes to inadequate supportcontributes to inadequate support and predisposes to eventualand predisposes to eventual fracture.fracture.  Sharp angles on the veneeringSharp angles on the veneering area should be rounded. Theyarea should be rounded. They produce increased stressproduce increased stress concentrations that can causeconcentrations that can cause mechanical failuremechanical failure www.indiandentalacademy.comwww.indiandentalacademy.com
  99. 99. 9999  Any deformation of theAny deformation of the metal frame work at themetal frame work at the junction can lead to thejunction can lead to the chipping porcelain.chipping porcelain. They are easierto useThey are easierto use because the backing is custombecause the backing is custom made fora space (no need tomade fora space (no need to adapt a premade porcelainadapt a premade porcelain facing to the space).facing to the space).www.indiandentalacademy.comwww.indiandentalacademy.com
  102. 102. 102102 FIBER REINFORCED ALLFIBER REINFORCED ALL RESINRESIN  AdvantagesAdvantages ►► Conservative,Conservative, esthetics,esthetics, ease ofease of repairrepair  DisadvantagesDisadvantages ►► Limited toLimited to short spanshort span  IndicationsIndications ►► High estheticHigh esthetic concernconcern  Contra indicationsContra indications ►► Long spanLong spanwww.indiandentalacademy.comwww.indiandentalacademy.com
  103. 103. 103103 Saddle/ridge lapSaddle/ridge lap ►►Not recommendedNot recommended ►►EstheticsEsthetics ►►Poor oral hygienePoor oral hygiene ►►Not recommendedNot recommended ►►Not recommendedNot recommended ►►Not applicableNot applicable  LocationLocation  AdvantagesAdvantages  DisadvantagesDisadvantages  IndicationsIndications  Contra indicationsContra indications  MaterialsMaterials www.indiandentalacademy.comwww.indiandentalacademy.com
  104. 104. 104104 Sanitary/hygienic  LocationLocation ►►Posterior mandiblePosterior mandible  AdvantagesAdvantages ►►Good access for oralGood access for oral hygienehygiene  DisadvantagesDisadvantages ►► Poor estheticsPoor esthetics  IndicationsIndications ►►Non esthetics zones&Non esthetics zones& impaired oralimpaired oral hygienehygiene  Contra indicationsContra indications ►►Where esthetic isWhere esthetic is importantimportant  MaterialsMaterials ►►All metalAll metal www.indiandentalacademy.comwww.indiandentalacademy.com
  105. 105. 105105 Modified ridge lapModified ridge lap  LocationLocation  AdvantagesAdvantages  DisadvantagesDisadvantages  IndicationsIndications  Contra indicationsContra indications   MaterialsMaterials ►►High esthetic ►►Good esthetics ►►Moderately easy to clean ►►Area with esthetic concern ►►Where minimal esthetic concern exist ►►Metal ceramic and all resin www.indiandentalacademy.comwww.indiandentalacademy.com
  106. 106. 106106 ConicalConical  LocationLocation  AdvantagesAdvantages  DisadvantagesDisadvantages  IndicationsIndications  Contra indicationsContra indications  MaterialsMaterials ►► Molars without estheticsMolars without esthetics ►► Good accesses For oralGood accesses For oral hygienehygiene ►► Poor estheticsPoor esthetics ►► PosteriorsPosteriors ►► Poor oral hygienePoor oral hygiene ►► All metals ,metalAll metals ,metal ceramics, all resinceramics, all resin www.indiandentalacademy.comwww.indiandentalacademy.com
  107. 107. 107107 OvateOvate  LocationLocation ►► Maxillary anteriors  AdvantagesAdvantages ►► Superior esthetics,ease of cleaning  DisadvantagesDisadvantages ►► Requires surgical preparation  IndicationsIndications ►► Optimal esthetics, high smile line  Contra indicationsContra indications ►► Un willingness for surgery  MaterialsMaterials ►► Metal ceramic, all resins www.indiandentalacademy.comwww.indiandentalacademy.com
  108. 108. www.indiandentalacademy.comwww.indiandentalacademy.com 108108