3. Introduction
• Pontics are the artificial teeth of a partial fixed dental prosthesis (FDP) that replace missing
natural teeth, restoring function and appearance.
• To design a pontic that meets hygienic requirements and prevents irritation of the residual
ridge, particular attention must be given to the form and shape of the gingival surface.
• The pontic must be carefully designed and fabricated not only to facilitate plaque control of
the tissue surface and around the adjacent abutment teeth but also to adjust to the existing
occlusal conditions.
4. • In addition to these biologic considerations, pontic design must incorporate mechanical
principles for strength and longevity, as well as esthetic principles for satisfactory
appearance of the replacement teeth.
• The pontic, as it mechanically unifies the abutment teeth and covers a portion of the residual
ridge, assumes a dynamic role as a component of the prosthesis and cannot be considered a
lifeless insert of gold, porcelain, or acrylic.
5. Definitions
ACCORDING TO GPT-8
• 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.
ACCORDING TO TYLMAN
• The suspended member of a fixed partial denture which replaces the lost
natural tooth, restores function and occupies the space of the missing tooth.
The Glossary of Prosthodontic Terms. The Journal of Prosthetic Dentistry. 2005;94(1):10-92.
Tylman SMalone W. Tylman's Theory and practice of fixed prosthodontics. 8th ed.
7. PRETREATMENT ASSESSMENT
I] PONTIC SPACE:
One function of FPD is to prevent tilting or drifting of the adjacent teeth into the
edentulous space.
Drifting / tilting
Reduced pontic space
Difficulty in fabricating pontic
8. Esthetic Zone
• Orthodontic alignment
• Abutment modification with
complete coverage retainers
Unaesthetic Zone
• Overly small pontics are
unacceptable
•Trap food
•Difficult to clean
• Careful diagnostic
waxing
• To determine most
appropriate
treatment
Increasing the proximal contours of adjacent teeth better than small pontic.
No functional/ esthetic deficit Maintain the space without any prosthodontic intervention
9. The edentulous ridge contour and topography should be carefully evaluated during the
treatment planning phase.
Features of Ideal Ridge Contour:
Smooth and regular surface of attached gingiva
Facilitate maintenance of plaque-free environment
Sufficient height and width
Mimic adjacent tooth contours
Appear to emerge from the ridge
Facially, free of frenal attachment
II] RESIDUAL RIDGE CONTOUR
10. Loss of residual ridge contour:
Unesthetic open gingival embrasures “BLACK TRIANGLES”
Food impaction
Percolation of saliva during speech
11. SIEBERT’S CLASSIFICATION
OF RESIDUAL RIDGE
DEFORMITIES :
A, Class O - no defect.
B, Class I defect- Faciolingual loss of tissue width with
normal ridge height.
C, Class II defect- Loss of ridge height with normal
ridge width.
D, Class III defect- a combination of loss in both
dimensions.
12. STATISTICS
91% residual ridge deformities
Anterior tooth loss
Majority are class III defects
Majority of patients with class II & class III defects
Unsatisfied with esthetics
Pre-prosthetic surgery
Ridge augmentation
13. SURGICAL MODIFICATION
Ridge augmentation with hard tissue grafts is not indicated unless it is to
receive an implant.
Class I Defects:
Infrequent
Not esthetically challenging
Soft tissue procedures recommended to improve width of the defect.
18. GINGIVAL ARCHITECTURE
PRESERVATION
Following tooth extraction- BUCCAL PLATE- Horizontal defect
Degree of RRR- 3-5mm- 6months and 50% width- 12months
Resulting deformities - unpredictable & not inevitable
Immediate restorative and periodontal intervention
Conditioning the extraction site
Providing matrix for healing
19. • Interim restoration
• Atraumatic extraction
• Scalloped architecture of interproximal
bone
• If bone levels are compromised :
1. Allograft materials
2. Hydroxyapatite
3. Tricalcium phosphate
4. Freeze dried bone
Can be grafted into the sockets
20. • The tissue side of the pontic should be:
• an ovate form - 2.5 mm apical to the facial free gingival
margin
• The pontic causes tissue blanching as it supports the
papillae and facial/palatal gingiva.
• The tissue side of the pontic must conform to within 1
mm of the interproximal and facial bone contour to act
as a template for healing.
• After approximately 1 month of healing, oral hygiene
access is improved by recontouring the pontic to
provide 1 to 1.5 mm of relief from the tissue.
21. Orthodontic
extrusion
• Avoids ridge augmentation
and gain vertical ridge
height
• However, Additional time
and expense of orthodontic
treatment, as well as
previous endodontic
treatment is necessary.
22. GOOD AESTHETICS
COLOR STABILITY
HYGIENE
NON-IRRITANT
MAINTENANCE OF SPEECH
MAINTENANCE OF TOOTH RELATIONSHIPS
IDEAL REQUIREMENTS OF PONTIC
23. PONTIC DESIGN CLASSIFICATION
• According to Rosenstiel
A] MUCOSAL CONTACT:
1. Ridge lap
2. Modified ridge lap
3. Ovate
4. Conical
B) NO MUCOSAL CONTACT
1. Sanitary (hygienic)
2. Modified sanitary (hygienic)
24. • Depending on shape of surface contacting the ridge (Tylmann)
1. Sanitary
2. Modified sanitary
3. Spheroidal
4. Saddle
5. Ridge lap
6. Modified ridge lap
7. Ovate
25. • According to the form (Johnston)
1. Sanitary or Hygenic
2. Anatomic type
• Based on materials used
1. Metal and porcelain veneered
2. Metal and resin veneered
3. All metal pontic
4. All ceramic pontic
26. • According to methods of fabrication
• Custom made pontic
• Prefabricated pontic
1. Trupontic
2. Interchangeable facing
3. Sanitary pontic
4. Pin-facing pontic
5. Modified pin-facing pontic
6. Reverse pin-facing pontic
7. Harmony pontic
8. Porelain fused to metal pontic
9. Prefabricated custom modified
27. PONTIC SELECTION
• Pontic selection depends primarily on esthetics and oral hygiene.
• ANTERIOR REGION
• POSTERIOR REGION
28. ANTERIOR PONTIC DESIGN
• A correctly placed anterior pontic should have
1. All surfaces convex, smooth and properly
finished.
2. Contact with the labial mucosa should be
minimal (pin point) and pressure free (lap
facing).
3. The lingual contour should be in harmony with
adjacent teeth or pontics.
Pontic- residual ridge relationship: A research report. Stein RS, J Prosthet Dent 1966; 16: 251
29. POSTERIOR PONTIC DESIGN
• A correctly designed pontic should have
1. All surfaces convex, smooth and properly finished.
2. Contact with the buccal contiguous slopes should be minimal (pin point) and pressure free
(modified ridge lap).
3. Occlusal table must be in functional harmony with the occlusion of all of the teeth
4. Buccal and lingual shunting mechanism should conform to those of the adjacent teeth.
5. The overall length of buccal surface should be equal to that of the adjacent abutments or
pontics.
Pontic- residual ridge relationship: A research report. Stein RS, J Prosthet Dent 1966; 16: 251
30. PRE-FABRICATED PONTIC FACINGS
• These are commercially available porcelain pontics
which can be altered by the dentist and reglazed if
necessary.
• These include:
• a) Trupontic – A horizontal tubular slot in the center of
the lingual surface of the facing.
• b) Interchangeable facings/flat back facing–
Manufactured with vertical slot running down the flat
lingual surface, this facing is retained with a lug which
engages the retention slot.
31. • c)Sanitary facing –flat occlusal
surface and a slot on the proximal
surface to fit into the metal
projections made in the FDP
• d) Pin facing – A flat lingual facing
with two horizontal pins for
retention.
32. • e) Modified Pin Facing- Facing
is modified by adding porcelain
to lingual gingival area of a pin
facing
• f)Reverse pin facing – Porcelain
denture teeth can be modified
to be used as the bridge facing.
Porcelain is added to the
gingival end of the facing and
multiple precision pin holes are
drilled into the lingual surface
33. • g) Harmony facing – This facing is
supplied with an uncontoured
porcelain gingival surface and
usually two retentive pins on the
flat lingual side.
• i) Pontips: Convex gingival surface
having pinpoint tissue contact and
attached to the backing occlusally
with retentive pins.
h) Porcelain fused to metal facing- Facing
consists of a metal core over which porcelain is
fused.
34. SANITARY OR HYGIENIC PONTIC
• Zero tissue contact
• Occlusal-gingival thickness should be atleast
3mm
• Convex mesiodistally and faciolingually
• Space beneath the pontic – 2mm ( Rosenstiel)
- 3 mm ( Tylman)
• Adequate space for cleaning
• Mandibular molars
35. Modified sanitary pontic
• Gingival portion is shaped like a concave archway mesiodistally between the retainers and
convex faciolingually.
• Allows increased connector size while decreasing the stress concentrated in the pontic
and connectors.
• Recommended for mandibular posteriors
36. ADVANTAGES:
1.Deflection is diminished in the center of the pontic.
2.Food retention impossible.
3.Makes it easy for the patient to remove debris.
4.Added bulk at the connectors: Stress reduced significantly.
5.Prevents undue flexure of fixed prosthesis.
6.Reshapes and reinforces critical solder joint region.
37. CONICAL PONTIC
• egg-shaped, bullet-shaped, or heart-
shaped
• Convex 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.
38. • The facial and lingual contours are dependent on width of the residual ridge;
• A knife-edged residual ridge necessitates flatter contours with a narrow tissue contact
area.
• Unsuitable for broad residual ridges
39. 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
40. • Socket-preservation techniques 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.
41. Modified ovate pontic
• The modified ovate pontic possess an ovate form with the apex
positioned more facially on the residual ridge rather than at the crest
of the ridge.
• Used where horizontal ridge width is not sufficient.
42. SADDLE PONTIC OR RIDGE LAP PONTIC
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.
The contact with the ridge extends beyond the midline of the edentulous ridge.
43. Saddle or ridge lap designs should be
avoided
The concave gingival surface of the pontic
is not accessible to cleaning with dental
floss>>>>plaque accumulation>>>>> tissue
inflammation.
44. MODIFIED RIDGE LAP
This design gives the illusion of a tooth, but it
possesses all or nearly all-convex surface for ease of
cleaning.
The lingual surface - slight deflection contour –
prevents food impaction and minimize plaque
accumulation.
Ridge contact must extend no further lingually than
the mid-line of the edentulous ridge.
45. The contour of the tissue contacting area of the pontic should be convex, this design with a
porcelain veneer is most commonly used pontic design in the appearance zone for both
maxillary and mandibular FPD.
Tissue contact should resemble a letter T whose vertical arm ends at the crest of the ridge.
Most common pontic form used in areas of high visibility--- maxillary and mandibular anterior
teeth and maxillary premolars and first molars
46. Cantilever
• FDPs in which only one side of the pontic is attached to a retainer are referred to as
cantilevered.
• long-term prognosis of the single abutment cantilever is poor.
• Forces are best tolerated by the periodontal supporting structures when directed in the
long axes of the teeth.
• A cantilever induces lateral forces on the supporting tissues, which may be harmful and
lead to tipping, rotation, or drifting of the abutment
47. • When multiple missing teeth are replaced, cantilever FDPs have considerable application.
• The harmful tipping forces are resisted by multiple abutment teeth, and movement of the
abutments is unlikely.
• Cantilevers are also successfully used with implant-supported prostheses.
49. BIOLOGIC CONSIDERATIONS
• The biologic principles of pontic design pertain to the maintenance and preservation of
the residual ridge, abutment and opposing teeth, and supporting tissue.
• Factors of specific influence are,
1. Ridge pontic contact
2. Amenability to oral hygiene
3. Direction of occlusal forces
50. RIDGE CONTACT
• Pressure free contact between the pontic and the underlying tissue
• When a pontic rests on mucosa, some ulcerations may appear as a result of the normal
movement of the mucosa in contact with the pontic.
• Positive ridge pressure (hyperpressure) may be caused by excessive scraping of the ridge
area on the definitive cast
51. If the pontic encroaches on the unattached mucosa an ulcer will form.
Hence the tip must be restricted to the keratinised gingiva itself
52. SUBPONTIC OSSEOUS HYPERPLASIA:
First described by Calman (1971) as painless, slow growing lesion on
edentulous ridge beneath FPD treatment due to following reasons:
Functional stresses or stimuli:- Photoelastic theory states that 1st molar
region is subjected to stresses during opening and closing loading.
Mild chronic irritation.
Bone under compression develops negative electric potential, that promote
osteogenesis associated with bone growth.
Treatment: Removal of FPD, surgical resection, recontouring of alveolar
ridge.
53. Pontic- residual ridge relationship: A research report
• To determine the frequency and the nature of tissue reaction of underlying the residual
ridge mucosa to specific pontic designs and various materials used in pontic constructions.
• Upon removal of pontics, inflammatory reactions of the underlying mucosa were found under
95 per cent of the pontics.
• The ideal design was shown to be a “modified ridge lap” in the posterior region and a “lap
facing” in the anterior region, with a pinpoint contact on the facial contiguous slope of the
residual ridge.
• The ideal design should include surface smoothness and a fine finish
• A successful artificial tooth replacement was characterized by a healthy tissue response
with the appearance of a lack of contact between the residual ridge and undersurface of the
pontic.
54. POST HYGIENE INSTRUCTIONS:
The chief reason for ridge irritation is the toxins released from microbial plaque, which
accumulates between the gingival surfaces of the pontic and residual ridge causing
inflammation and calculus formation.
The gingival embrasures of the pontic should be wide open to allow the patient easy access
for cleaning and the contact between the pontic
tissue must allow the passage of floss from one retainer to another.
55. Triphodakis (1990) showed in his study that tissues under a pontic can be maintained in an
inflammation-free condition if the patient flosses at least once a day there will be imprint or
foot print of the pontic on the ridge without inflammation.
Devies such as proxy brushes, super floss and dental floss are highly recommended.
56. PONTIC MATERIAL
• Should provide good esthetic results, biocompatibility, rigidity, and strength to withstand
occlusal forces; and longevity.
• 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.
• Investigations into the biocompatibility of materials used to fabricate pontics have centered
on two factors :
1. The effect of the materials and
2. The effects of surface adherence.
57. • Well-polished gold is smoother, less prone to corrosion, and less retentive of plaque than an
unpolished or porous casting.
• For easier plaque removal and biocompatibility, the tissue surface of the pontic should be
made in glazed porcelain
• However, ceramic tissue contact may be contraindicated in edentulous areas where there is
minimal distance between the residual ridge and the occlusal table.
58. OCCLUSAL FORCES
• Reducing the buccolingual width of the pontic by as much as 30%
• 12% increase in chewing efficiency can be expected from a one third reduction of pontic width.
• Narrowing the occlusal table may actually impede the development of a harmonious and stable
occlusal relationship
• Difficulties in plaque control and improper cheek support.
• Pontics with normal occlusal widths (at least on the occlusal third) are generally recommended.
• One exception is if the residual alveolar ridge has collapsed buccolingually.
• Reducing pontic width may then be desired, thereby lessening the lingual contour and
facilitating plaque control measures.
59. MECHANICAL CONSIDERATIONS
• Mechanical problems may be caused by
1. improper choice of materials
2. poor frame work design
3. poor tooth preparation
4. poor occlusion.
• Therefore, evaluating the likely forces on a pontic and
designing accordingly are important.
• For example, 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.
61. METAL CERAMIC PONTICS
• A well fabricated metal ceramic pontic is strong,
easy to keep clean, and looks natural.
• The framework must provide a uniform veneer of
porcelain (approximately 1.2 mm).
• The 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 metal-porcelain junction
62. RESIN-VENEERED PONTICS
• Resistance to abrasion is lower than enamel or
porcelain,
• no chemical bond existed between the resin and
the metal framework,
• Continuous dimensional change of the veneers
often caused leakage at the metal-resin
interface, with subsequent discoloration of the
restoration.
• New-generation indirect resins
• High flexural strength, minimal polymerization
shrinkage, and wear rates comparable with those
of tooth enamel
63. 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.
• Excellent marginal adaptation and esthetics
65. ESTHETIC CONSIDERATIONS
These are situations which require a more conservative approach.
The patient’s inability to undergo surgery or an unwillingness to consider it will force the
considerations of alternative form.
If bridges have 2 or more pontic used to fill the edentulous space, black triangles can be very
unaesthetic; they collect plaque, interfere with passage of floss, and reduce the rigidity of
the pontic span.
Pink porcelain can be added to gingival position in the embrasure area of the pontic; although
the shade rarely matches with the hue of the patient the gingival extension must be
supported by metal framework.
Elimination of interpontic embrasure in a multitooth pontic may limit or eliminate soft tissue
proliferation.
66. THE GINGIVAL INTERFACE
• An esthetically successful pontic will replicate the
form, contours, incisal edge, gingival and incisal
embrasures, and color of adjacent teeth.
• The pontic’s simulation of a natural tooth is most
often betrayed at the tissue pontic interface.
• Special attention should be paid to the contour of
the labial surface as it approaches the pontic-tissue
junction to achieve a “natural” appearance.
• If the original tooth contour were followed, the
pontic would look unnaturally long incisogingivally
67. • 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
• However, when appearance is of utmost
concern, the ovate pontic, used in
conjunction with alveolar preservation
or soft tissue ridge augmentation-
provide an appearance at gingival
interface just like adjacent natural
teeth.
68. • Special care must be taken when
studying where shadows fall around
natural teeth, particularly around the
gingival margin.
• If a pontic is poorly adapted to the
residual ridge, there will be an
unnatural shadow in the cervical area
>> spoils the illusion of a natural tooth.
• Recesses occurring at the gingival
interface collect food debris, further
betraying the illusion of a natural
tooth.
69. INCISOGINGIVAL LENGTH
• Ridge resorption will make a pontic look too long in the cervical region.
• An abnormal labiolingual position or cervical contour, however, is not immediately obvious.
• This fact can be used to produce a pontic of good appearance by recontouring the gingival
half of the labial surface
70. • In areas where tooth loss is
accompanied by excessive loss of
alveolar bone, the pontic is shaped
to simulate a normal crown and root
with emphasis on the
cementoenamel junction.
• The root can be stained to simulate
exposed dentin
71. GINGIVA-COLORED CERAMICS
• If augmentative measures are contraindicated
or undesirable, small alveolar deficiencies and
missing papillae can be reconstructed by
restorative measures.
• The exact shade of the gingiva has to be
established with special gingival shade guides.
• The basal surface must demonstrate a convex
shape similar to the ovate pontic designs for
the dental floss to establish tight contact with
all the surface areas.
Daniel E , H Spiekermann: A review of esthetic pontic design options. Quintessence Int 2002;33:736-746
72.
73. ALL-CERAMIC GINGIVAL MASKS
• Separately fabricated ceramic gingival
masks can be used to make subsequent
adjustments in permanently placed
restorations.
• This method is particularly suitable for
patients with a local alveolar ridge
defect that has not been corrected by
augmentation of the soft tissue.
Daniel E , H Spiekermann: A review of esthetic pontic design options. Quintessence Int 2002;33:736-746
74. MESIODISTAL WIDTH
• Frequently, the space available for a pontic will be greater or smaller than the width
of the contra lateral tooth.
• If possible, such a discrepancy should be corrected by orthodontic treatment.
• If this is not possible, an acceptable appearance may be obtained by incorporating
visual perception principles into the pontic design.
75. • The features of the contra lateral tooth
should be duplicated as precisely as possible
in the pontic, and the space discrepancy can
be compensated by altering the shape of the
proximal areas.
• The retainers and the pontic can be
proportioned to minimize the discrepancy.
• In this situation a diagnostic waxing
procedure will help solve a challenging
restorative problem.
76. • Space discrepancy presents less of a
problem when posterior teeth are being
replaced because their distal halves are
not normally visible from the front.
• Discrepancy here can be managed by
duplicating the visible mesial half of the
tooth and adjusting the size of the distal
half.
77. Fiber -reinforced Composite Fixed Dental
Prostheses with Various Pontics
• PURPOSE: To evaluate the load-bearing capacities of fiber-reinforced composite (FRC) fixed
dental prostheses (FDP) with pontics of various materials and thicknesses.
• MATERIALS: 72 FDPs with frameworks made of continuous unidirectional glass fibers
(everStick C&B) were fabricated. Three different pontic materials were used: glass
ceramics, polymer denture teeth, and composite resin. The FDPs were divided into 3
categories based on the occlusal thicknesses of the pontics (2.5 mm, 3.2 mm, and 4.0 mm).
78. • CONCLUSION:
• By increasing the occlusal thickness of the pontic, the loadbearing
capacity of the FRC FDPs may be increased.
• The highest load-bearing capacity was obtained with 4.0 mm thickness
in the ceramic pontic.
• However, with thinner pontics, polymer denture teeth and composite
pontics resulted in higher load-bearing values
Fiber-reinforced Composite Fixed Dental Prostheses with Various Pontics The Journal of Adhesive Dentistry2014Vol 16, No 2
80. • Primary use: Temporary Bridges
• Plastic to fabricate quick and economical temporary bridges.
• Wear-resistant, vacuum processed synthetic resin
• Special lingual channel ensures pontic locks into the plastic
81. Conclusion
Designs that allow easy plaque control are especially important to a pontic’s
long term success.
Minimizing tissue contact by maximizing the convexity of the pontic’s gingival
surface is essential.
Special consideration is also needed to create a design that combines easy
maintenance with natural appearance and adequate mechanical strength.
When the appropriate design has been selected, it must be accurately
conveyed to the dental technician.
82. References
• Rosenstiel S F et al : Contemporary Fixed Prosthodontics, 4th edn Missouri, Mosby Inc, pg 513
• Shillingburg H T et al : Fundamentals of fixed prosthodontics, ed 4, Chicago , Quintessence
Publishing, pg 485
• Tylman SMalone W. Tylman's Theory and practice of fixed prosthodontics. 8th ed.
• The Glossary of Prosthodontic Terms. The Journal of Prosthetic Dentistry. 2005;94(1):10-92.
• Pontic- residual ridge relationship: A research report. Stein RS, J Prosthet Dent 1966; 16: 251
• Daniel E , H Spiekermann: A review of esthetic pontic design options. Quintessence Int
2002;33:736-746
• Fiber-reinforced Composite Fixed Dental Prostheses with Various Pontics The Journal of
Adhesive Dentistry2014Vol 16, No 2
• Korman R. Enhancing Esthetics with a Fixed Prosthesis Utilizing an Innovative Pontic Design
and Periodontal Plastic Surgery. Journal of Esthetic and Restorative Dentistry. 2014;27(1):13-
28.
