Artificial teeth of fpd that replaces missing natural teeth

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PONTICS
Dr. Ibadat Jamil
Assistant professor
Dep. Of Prothodontics

2. Pontics are the artificial teeth of a fixed partial denture that
replace missing natural teeth, restoring function and
appearance.
The word pontic is derived from the Latin
word pons, meaning bridge.
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3. FACTORS CONTROLLING THE DESIGN
OF A PONTIC:
A.PONTIC SPACE
B.RESIDUAL RIDGE CONTOUR
C.GINGIVALARCHITECTURE
PRESERVATION
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A. PONTIC SPACE
Optimum space must be available for
placement of pontic.
Pontic space can be increased by :
a. Orthodontic repositioning of abutments
b. Increasing the proximal contours of
adjacent
Undersized pontic is highly
contraindicated:
• In anterior region : because of esthetics
• In posterior region: because of food
entrapment and difficulty to clean
Individual crowns of increased proximal
contours were preferred to an FPD with
undersized pontics. teeth.

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•An ideally shaped ridge has a smooth, regular surface of attached
gingiva, which facilitates maintenance of a plaque-free
environment.
•Its height and width should allow placement of a pontic that
appears to emerge from the ridge and mimics the appearance of
the neighboring teeth.
• Facially, it must be free of frenum attachment and of adequate
facial height to sustain the appearance of interdental papillae.

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Loss of residual ridge contour may lead to:
a. unesthetic open gingival embrasures ("black triangles")
b. food impaction
c. percolation of saliva during speech.
LINGUAL VIEW OF OPEN GINGIVAL
EMBRASSURES ON A FPD REPLACING
MANDIBULAR INCISORS
FOOD IMPACTION

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Siebert ( acc to an article published in 1983)has classified residual
ridge deformities into three categories:
• Class I defects-faciolingual loss of tissue width with normal ridge height.
•Class II defects-loss of ridge height with normal ridge width.
•Class III defects-a combination of loss in both dimensions.(MAJORITY)

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CLASS I DEFECTS:
•INFREQUENT
•NOT ESTHETICALLY CHALLENGING
TREATED WITH SOFT TISSUE
PROCEDURES:
i. ROLL TECHNIQUE
ii. POUCH TECHNIQUE

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CLASS II AND CLASS III
DEFECTS
INTERPOSITIONAL
GRAFT
ONLAY GRAFT
•Variation of pouch technique.
•Wedge shaped connective
tissue graft is inserted into a
pouch prepared on facial aspect
of residual ridge
•If height of the ridge is to be
increased ,then epithelial part of
wedge may be positioned
coronally to the surrounding
epithelium
•Designed to gain ridge
height but also contributes
to ridge width and is
considered for having a
higher potential to
increase ridge height than
interpositional graft.
•It is a THICK FREE
GINGIVAL GRAFT
harvested from partial or
full thickness palatal
donor sites

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INTERPOSITIONAL
GRAFT

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A, Presurgical view of Class
III residual ridge defect with
abutment teeth prepared.
B, Recipient bed prepared by
removing epithelium.
C, Striation cuts are made in
connective tissue to
encourage revascularization.
D, Onlay graft is
sutured in place.
A B
O
N
L
A
Y
G
R
A
F
T

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C. GINGIVAL ARCHITECTURE
PRESERVATION
•Preservation of the alveolar process can be achieved through immediate
restorative and periodontal intervention at the time of tooth removal.
• By conditioning the extraction site and providing a matrix for healing, the
pre-extraction gingival architecture (or "socket") can be preserved.
•Preparing the abutment teeth before the extraction is the preferred
technique. A provisional FPD can be fabricated indirectly, ready for
immediate insertion.
• Because socket preservation is dependent on underlying bone contour, the
extraction of the tooth to be replaced should be atraumatic and aimed at
preserving the facial plate of bone.
•The scalloped architecture of interproximal bone forming the extraction
site is essential for proper papilla form, as are facial bone levels in the
prevention of alveolar collapse.
•If bone levels are compromised before or during extraction, the sockets
can be grafted with an allograft material (hydroxyapatite, tricalcium
phosphate, or freeze-dried bone).

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Alveolar architecture preservation technique.
A, Atraumatic tooth
extraction
B, Cross section view of the
immediate provisional FPD
demonstrating ovate pontic
form.
C, Provisional restoration.
Note the 2.5-mm apical
extension of the ovate
pontic.
D. The seated provisional
should cause slight blanching
of interdental papilla
E. Provisional restoration 12 months after
extraction. Note the preservation of interdental
papilla.

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PONTIC DESIGN
CLASSIFICATION
MUCOSAL CONTACT
• RIDGE LAP
• MODIFIED RIDGE LAP
• OVATE
• CONICAL
NO MUCOSAL
CONTACT
• SANITARY(HYGIENIC)
• MODIFIED
SANITARY(HYGIENIC)

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SANITARY OR HYGIENIC PONTIC
FISH BELLY
•LEAST "TOOTHLIKE“ DESIGN –
HENCE PREFFERED IN
MANDIBULAR 1ST MOLAR REGION
•FOOD ENTRAPMENT
•RESTORES OCCLUSAL FUNCTION
.
•STABILIZES ADJACENT AND OPPOSING TEETH.
•FREQUENTLY USED IN ALL CONVEX CONFIGURATION
(FACIOLINGUALLY AND MESIODISTALLY)

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•EASY CLEANING/EASY FLOSSING-
 UNDERSURFACE ROUND
TISSUE SURFACE CLEAR OF RESIDUAL RIDGE

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•. Its gingival portion is shaped like a concave archway between the
retainers(mesio-distally).
•Undersurface is convex facio-lingually – giving tissue facing surface of
pontic the configuration of HYPERBOLIC PARABOLOID
• This geometry permits increased connector size while decreasing the
stress concentrated in the pontic and connectors.“
• It is also less susceptible to tissue proliferation that can occur when a
pontic is too close to the residual ridge
MODIFIED SANITARY PONTIC / PEREL PONTIC /
ARC-FIXED PARTIAL DENTURE

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SADDLE OR RIDGE LAP PONTIC
A, Cross-section view of ridge lap pontic.
B, The tissue surface is inaccessible to
cleaning devices.
A classic saddle or ridge lap
pontic
B. A contact with ridge that extends beyond midline of
edentulous ridge or a sharp angle at linguogingival aspect of
tissue contact constitutes ridge lap.

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•Has a concave fitting surface that overlaps the residual ridge
buccolingually –
Simulates the contours and emergence profile
of the missing tooth on both sides of the residual ridge
UNCLEAN /UNCLEANABLE DESIGN:
since floss cannot traverse the tissue facing area of pontic
therefore it bridges across the linguogingival and faciogingival
angles of pontic
CAUSES TISSUE INFLAMMATION: therefore should not
used

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MODIFIED RIDGE LAP PONTIC
MODIFIED RIDGE LAP
A. MAXILLARY
B. B. MANDIBULAR
•Gives ILLUSION of a tooth but possesses
all or nearly convex surfaces for easy
cleaning.
•Lingual surface should have a slight
deflective contour to prevent food
impaction and reduce plaque accumulation.
•On the facial side of the ridge ,there
might be a slight faciolingual concavity so
as to keep the pontic clean and tolerated by
the tissue as long as tissue contact is narrow
mesiodistally and faciolingually.
•Tissue contacting area of the pontic must
be CONVEX whenever possible.
•This design with porcelain veneer is most
commonly used in the appearance zone.

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FPD PARTIALLY SEATED
FPD FULLY SEATED

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Tissue contact of the modified ridge lap pontic
must resemble the letter ‘T’ with vertical arm
ending on the crest of the ridge
GINGIVAL VIEW OF MAXILLARY FPD

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CONICAL PONTIC
•EGG-SHAPED, BULLET-SHAPED, OR HEART-
SHAPED
•Easy to clean
•Should be kept as convex as possible with only one
point of contact at the center of the residual ridge.
•Recommended for the replacement of mandibular
posterior teeth where esthetics is a lesser concern
•The facial and lingual contours are dependent on the
width of the residual ridge; a knife-edged residual
ridge will necessitate flatter contours with a narrow
tissue contact area.
• Unsuitable for broad residual ridges, because the
emergence profile associated with the small tissue
contact point may create areas of food entrapment

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CONICAL PONTIC OVER A
THIN RIDGE: INDICATED
CONICAL PONTIC OVER A BROAD
RIDGE : CONTRINDICATED

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OVATE PONTIC
•MOST ESTHETICALLY APPEALING -Its convex tissue surface resides in a soft
tissue depression or hollow in the residual ridge, which makes it appear that a tooth is
literally emerging from the gingiva .
•Socket-preservation techniques, which have already been described, should be performed
at the time of extraction to create the tissue recess from which the ovate pontic form will
emerge .
•For a preexisting residual ridge, soft tissue surgical augmentation is typically required.
•When an adequate volume of ridge tissue is established, a socket depression is sculpted
into the ridge with surgical diamonds or electrosurgery.
• The ovate pontic's advantages include
 its pleasing appearance and
its strength.
 its recessed form is not susceptible to food impaction.
•When used successfully with ridge augmentation, its emergence from the ridge appears
identical to that of a natural tooth.

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OVATE PONTIC FITTING INTO THE
DEPRESSION OF THE RIDGE
•broad convex geometry of ovate pontic is
stronger than that of the modified ridge lap
pontic, because the unsupported, thin porcelain
that often exists at the gingivofacial extent of the
pontic is eliminated

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PARTIALLY SEATED FPD
FULLY SEATED FPD

30. BIOLOGIC
• CLEANSIBLE
TISSUE SURFACE
• ACCESS TO
ABUTMENT
TOOTH
• NO PRESSURE ON
RIDGE
MECHANICAL
• RIGID( TO RESIST
DEFORMATION)
• STRONG
CONNECTORS(TO
PREVENT
FRACTURE)
• METAL CERAMIC
FRAMEWORK TO
RESIST
PORCELAIN
FRACTURE
ESTHETIC
• SHAPED TO LOOK
LIKE THE TOOTH
IT REPLACES
• APPEARS TO
GROW OUT OF
EDENTULOUS
RIDGE
• SUFFICIENT
SPACE FOR
PORCELAIN
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CONSIDERATIONS FOR SUCCESSFUL PONTIC
DESIGN

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BIOLOGIC PRINCIPLES OF
PONTIC DESIGN
FOUR FACTORS:
1. PONTIC-RIDGE CONTACT,
2. ORAL HYGIENE CONSIDERATIONS
3. PONTIC MATERIAL
4. THE DIRECTION OF OCCLUSAL FORCES

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1. PONTIC –RIDGE CONTACT
•Pressure-free contact between the pontic and the
underlying tissues is indicated to prevent ulceration and
inflammation of the soft tissues .
•If any blanching of the soft tissues is observed at try-in,
the pressure area should be identified with a disclosing
medium (i.e., pressure-indicating paste) and the pontic
recontoured until tissue contact is entirely passive.

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2. ORAL HYGIENE CONSIDERATIONS
•The chief cause of ridge irritation is the
toxins released from microbial plaque,
which accumulate between the gingival
surface of the pontic and the residual
ridge, causing tissue inflammation and
calculus formation.
•Gingival embrasures around the
pontic should be wide enough to
permit oral hygiene aids. However, to
prevent food entrapment, they should
not be opened excessively
The patient must be instructed how
to clean the gingival surface of a
pontic with floss.

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3.PONTIC MATERIAL
IDEAL REQUISITES FOR A
MATERIAL TO BE USED
FOR PONTIC
FABRICATION:
good esthetics
biocompatibility,
rigidity,
strength to withstand
occlusal Forces
longevity
FPDs should be made as rigid as
possible, because any flexure
during mastication or parafunction
may cause pressure on the gingiva
and cause fractures of the veneering
material.
Occlusal contacts should not fall
on the junction between metal and
porcelain during centric or
eccentric tooth contacts, nor should
a metal ceramic junction occur in
contact with the residual ridge on
the gingival surface of the pontic.

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• Glazed porcelain –
• most biocompatible
• easier to clean than other materials
•Well polished gold: is smoother
less prone to corossion
less retentive to plaque
•However highly polished gold may cause accumulation
of plaque if oral hygiene is not maintained

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4.OCCLUSAL FORCES
•Reducing the buccolingual width of the pontic by as much
as 30% has been suggested as a way to lessen occlusal forces
on, and thus the loading of, abutment teeth.
•In fact, narrowing the occlusal table may actually impede or
even preclude the development of a harmonious and stable
occlusal relationship. Like a malposed tooth, it may cause
difficulties in plaque control and may not provide proper cheek
support. Therefore pontics with normal occlusal widths are
generally recommended.
•If the residual alveolar ridge has collapsed Buccolingually,
Reducing pontic width may then be desired, in order to reduce
the lingual contour and facilitate plaque-control measures.

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MECHANICAL CONSIDERATIONS
AFFECTING THE PONTIC DESIGN
Mechanical problems may be caused by:
a. improper choice of materials,
b. poor framework design,
c. poor tooth preparation, or
d. poor occlusion.
These factors can lead to fracture of the prosthesis
or displacement of the retainers.
•a strong all-metal pontic may be needed in high-stress situations rather
than a metal-ceramic pontic which would be more susceptible to fracture.
When metal ceramic pontics are chosen, extending porcelain onto the
occlusal surfaces to achieve better esthetics should also be carefully
evaluated. In addition to its potential for fracture, porcelain may abrade the
opposing dentition if the occlusal contacts are on enamel or metal.

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AVAILABLE PONTIC MATERIALS
FPDs may be fabricated using :
1. All metal
2. All porcelain
3. All acrylic
4. Metal porcelain (most common)

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METAL-CERAMIC PONTICS.
•Most pontics are fabricated by the metal-ceramic technique.
•Advantages:
 strong,
 easy to keep clean
looks natural.
•Disadvantage:
mechanical failure can occur mostly because of inadequate
framework design.

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•The framework must provide a uniform veneer of porcelain (approximately
1.2 mm).
•Excessive thickness of porcelain contributes to inadequate support and
predisposes to eventual fracture .This is often true in the cervical portion of an
anterior pontic.
•A reliable technique for ensuring uniform thickness of porcelain is to wax the
fixed prosthesis to complete anatomic contour and then accurately cut back the
wax to a predetermined depth.
Wax up to complete
anatomc contour
Using pkt no.4 carver ,cut back those parts
of the pattern which will be veneered with
porcelain
Using a spoon excavator
shape the metal ceramic
junction

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•metal surfaces to be veneered must be smooth and
free of pits.
• Sharp angles on the veneering area should be
Rounded.
• occlusal centric contacts must be placed at least
1.5 mm away from the junction.

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RESIN-VENEERED PONTICS
•ACRYLIC RESIN-VENEERED RESTORATIONS:
Disadvantages:
Their resistance to abrasion was lower than
enamel or porcelain, and noticeable wear
occurred with normal toothbrushing .
Because no chemical bond existed between
the resin and the metal framework, the resin was
retained by mechanical means (e.g., undercuts).
Continuous dimensional change of the
veneers often caused leakage at the metal-
resin interface, with subsequent discoloration
of the restoration.

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ADVANTAGES TO USING POLYMERIC MATERIALS
INSTEAD OF CERAMICS:
• Easy to manipulate
•Easy to repair
•Do not require the high-melting range alloys needed for
metal-ceramic techniques.

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FIBER-REINFORCED COMPOSITE
RESIN PONTICS.
•Composite resins can be used in fixed partial
dentures without a metal substructure.
•A substructure matrix of impregnated glass or
polymer fiber provides structural strength.
•The physical properties of this system, combined
with its excellent marginal adaptation and
esthetics, make it a possible metal-free alternative
for FPDs
•But long term clinical performance is not yet
known.

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ESTHETIC CONSIDERATIONS
•An esthetically successful pontic will replicate the form, contours, incisal
edge, gingival and incisal embrasures, and color of adjacent teeth.
•The greatest challenge here is to compensate for anatomic changes that
occur after extraction.
•Special attention should be paid to the contour of the labial surface as it
approaches the pontic-tissue junction to achieve a "natural" appearance.
•This cannot be accomplished by merely duplicating the facial contour of the
missing tooth, because after a tooth is removed, the alveolar bone undergoes
resorption and/or remodeling.
If the original tooth contour were followed, the pontic would look
unnaturally long incisogingivally

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•The modified ridge-lap pontic is recommended for most anterior
situations; it compensates for lost buccolingual width in the residual ridge
by overlapping what remains.
•Rather than emerging from the crest of the ridge as a natural tooth would,
the cervical aspect of the pontic sits in front of the ridge, covering any
abnormal ridge morphology resulting from tooth loss.
• When appearance is of utmost concern, the ovate pontic, used in
conjunction with alveolar preservation or soft tissue ridge augmentation, can
provide an appearance at the gingival interface that is virtually
indistinguishable from a natural tooth.

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