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  1. 1. Pontics Preeti kalia IInd year PG student Dept of ProsthodonticsA.E.C.S Maaruti College of Dental Sciences
  2. 2. Pontics Definition Requirements Design Pretreatments assessment TypesFabrication
  3. 3. 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
  4. 4. 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.
  5. 5. 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
  6. 6. Ideal requirement of pontics Facilitate plaque control Emergence profile Strength and longevity Be esthetic
  7. 7. Ideal requirements of pontics Restore function No abutment overloading Color stable
  8. 8. Functions of pontics Mastication Speech Esthetics
  9. 9. Considerations for asuccessful pontic design
  10. 10. Biologic considerationsRidge contact Area of contact with ridge should be small and convex.
  11. 11. Oral hygiene considerations
  12. 12. Pontic materials
  13. 13.  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 onesWise. M et al and Dykema .R, The plaque-retaining capacity of four dentalmaterials,J Proshtet 1975;33:178
  14. 14. 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
  15. 15. Mechanical considerations Improper choice of materials Poor framework design Poor tooth preparation Poor occlusion
  16. 16.  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 ProsthetDent 33:54-59, 1975
  17. 17. Esthetic considerations
  18. 18. Incisogingival length Root can be stained to simulate exposed dentine. Pink porcelain to simulate the gingival tissues
  19. 19. Mesiodistal width Space discrepancy – less problem in posteriors
  20. 20. Mesiodistal width  Orthodontic treatment  Pontic of abnormal size- illusion of natural tooth
  21. 21. Pretreatment assessmentDiagnostic cast Wax up
  22. 22. Pontic space Individual crowns of increased proximal contours were preferred to an FPD with undersized pontics
  23. 23. Residual ridge contour Food entrapment Loss of residual ridge contour leading to unesthetic open gingival embrasures
  24. 24. Residual ridge contour Class I defect. Class II defect. Class III defect. Sieberts classification
  25. 25. Residual ridge contourAbrams et al showedClass I defects to constitute 32.4%Class II- 2.9%Class III- 55.9%8.8% having no defects
  26. 26. Surgical management of class Idefect Pouch technique
  27. 27. Surgical management of class Idefect Pouch technique
  28. 28. Surgical management of class IIand III defect Interpostional graft
  29. 29. Surgical management of class IIand III defect onlay graft
  30. 30. Gingival architecture preservation
  31. 31. Classification1. Depending on shape of surface contacting the ridge(Tylmann) Sanitary Modified sanitary Spheroidal Saddle Ridge lap Modified ridgelap Ovate
  32. 32. 2.According to Rosenstiel dependingon mucosal contact A. mucosal contact ridge lap modified ridge lap ovate conical B. No mucosal contact sanitary(hygenic) modified sanitary
  33. 33. 3.According to the form(Johnston) Sanitary or Hygenic Anatomic type4.Based on materials used Metal Metal and porcelain Metal and resin
  34. 34. 5.Prefabricated ponticsFlat back Trupontic Longpinfacing Pontips Reverse pin facings
  35. 35. Sanitary or hygienic
  36. 36. Modified sanitary pontic
  37. 37. Ridge lap pontic
  38. 38. Modified ridge lap pontic
  39. 39. Conical pontic
  40. 40. Ovate pontic
  41. 41. Modified ovate pontic Contact more labially than ovate pontic Easier to clean No need of surgical augmentation Push the labial gingival margin away to flossLiu.S,J Esthet Restor Dent 16:273-283, 2004
  42. 42. 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
  43. 43. 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
  44. 44. Metal ceramic pontics wax the prosthesis
  45. 45. All ceramic pontics
  46. 46. Resin veneered pontics
  47. 47. Fiber reinforced compositeresin pontics
  48. 48. Pontic fabrication All metal hygienic pontic Metal ceramic pontic
  49. 49. 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
  50. 50. All metal hygienic pontic fabrication
  51. 51. All metal hygienic pontic fabrication
  52. 52. All metal hygienic pontic fabrication
  53. 53. All metal hygienic pontic fabrication
  54. 54. All metal hygienic pontic fabrication
  55. 55. Metal ceramic pontics Requirements  Adequate bulk of metal  Uniform thickness of porcelain  Continuous strip of metal on lingual surface
  56. 56. Scalloped or trestle design Connector is diminished in faciolingual dimension – Indication Bulk or rigidity in connector areas Tissue contact – modified ridge lap
  57. 57. 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
  58. 58. Metal ceramic pontics  Check the alignment in a mesiodistal and the facial profile
  59. 59. Metal ceramic pontics
  60. 60. Metal ceramic pontics
  61. 61. Available pontic systems Advantages Disadvantages Indications ContraindicationsMetal Esthetics Difficult if Most Long span withceramic Biocompatible abutment not situations high stress metal ceramicAll metal Strength Non esthetic Mandibular Esthetics Straightforward molars, procedure under high bite forceFibre Conservative Limited to short Esthetics Long spanreinforced with inlays spansall resin EstheticsFacings Rarely used Rarely used Rarely used Rarely used
  62. 62. Review of literatureKumbulolu.O et al, A Different Pontic Design for Fiber-Reinforced Composite Bridgeworks: A Clinical Report, Eur J Dent. 2007 January; 1(1): 50–53.
  63. 63. Review of literatureKim.T.H.Yet al, Simulated tissue using unique pontic design, JProsthet Dent 2009;102:205-210
  64. 64. References Malone W.F.P., Koth D.L., Cavazos E. : Tylman’s 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
  65. 65. 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
  66. 66. 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 16:273- 283, 2004
  67. 67. References Kumbulolu.O et al, A Different Pontic Design for Fiber-Reinforced CompositeBridgeworks: A Clinical Report, Eur J Dent. 2007 January; 1(1): 50–53.Kim.T.H.Yet al, Simulated tissue using unique pontic design, J Prosthet Dent 2009;102:205-210
  68. 68. References R.Duane Douglas ,Pontic design FPDpontic wax up .ppt FPD.ppt