Definitions
Pre-treatment assessment and management
Principles of pontic design
Specifications for pontic design
Classifications
Individual design according to Rosenstiel
Other type of pontics
Split pontic technique
Multiple hygiene pontics
Free-end pontics
Bonded pontics
Fiber reinforced composite resin pontics
Use of Natural Tooth as a Pontic
Post operative care
Conclusion
3. Presented by:
Dr. Ch.Praveena,
Second year Graduate student,
Dept. of Prosthodontics and Crown &Bridge,
Sibar Institute of Dental Sciences,
Guntur-09.
Seminar on
PONTICS IN FPD
4. Contents
• Introduction
• Definitions
• Pre-treatment assessment and management
• Principles of pontic design
• Specifications for pontic design
• Classifications
• Individual design according to Rosenstiel
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Pontics in FPD- 84
5. • Other type of pontics
– Split pontic technique
– Multiple hygiene pontics
– Free-end pontics
– Bonded pontics
– Fiber reinforced composite resin pontics
– Use of Natural Tooth as a Pontic
• Post operative care
• Conclusion
• Bibliography and References
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Pontics in FPD- 84
6. Previous questions
• Analyse the importance of pontic designing in
preservation of the periodontium and abutment
(NTRUHS 2002, 20marks)
• Ovate pontic (RGUHS 2004, 20 marks)
• Classify pontic design in FPD (RGUHS 2009, 10
marks)
• Discuss the pontics in FPD design
• Discuss the present day concept and principles in
designing the pontics in FPD
• Prosthesis with special references to pontic design
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8. • Pontic name is derived from the Latin word pons,
meaning bridge.
• It is not a simple replacement, because placing an exact
anatomic replica of the tooth in the space is difficult as it
interferes with hygiene maintenance.
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Pontics in FPD- 84
9. Definitions
• “ An artificial teeth on a fixed dental prosthesis that
replaces a missing natural teeth, restores it’s function,
and usually fills the space previously occupied by the
clinical crown. “
GPT-8
• Tylman defines pontic as “the suspended member of a
fixed partial denture. It replaces the lost natural tooth,
restores function and occupies the space of the missing
tooth.”
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Pontics in FPD- 84
10. History
• Ancient relics of early civilization
– detached natural teeth from one mouth adjusted
to another by means of ligature wires
• Phoeniceans were the first to construct dental bridge
work
• Kerr & Roger in 1877 suggested that teeth of ivory or
bone secured by copper wire or catgut string .
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11. • Pierre Fouchard 1923- Father of modern
dental prosthesis.
He used “Tenons” which were in reality
dowels or pivots screwed into the roots to
retain some of his bridges.
• Seldberg in 1936
– Gold or porcelain or combination of two
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13. Pontic space
• Assessment for adequate function,
esthetic and also selection of
design.
• Way to assess clinical intraoral
examination, diagnostic cast and
mounting, radiographs.
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14. • Determination of pontic space
• One function of an FPD is to prevent
tilting or drifting of the adjacent teeth
into the edentulous space.
• Supra eruption
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Pontics in FPD- 84
15. • If pontic space is less, conditions increasing the
proximal contours of the adjacent teeth may be
better than making an FPD with under sized pontics.
• Small pontics are unacceptable because they trap
food and are difficult to clean.
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Pontics in FPD- 84
16. Residual ridge contour
• Ridge width and height should allow
the placement of pontic that appears
to emergence from the ridge.
• It must be free of high Frenal
attachment.
• Loss of residual ridge contour leads to
black triangles, food impaction and
percolation of saliva during speech.
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Pontics in FPD- 84
17. Residual ridge defects
Siebert classification
• Class I defects- faciolingual
loss of tissue width with
normal ridge height.
• Class II defects- loss of ridge
height with normal ridge
width.
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Pontics in FPD- 84
Class II defect
Class I defect
18. • Class III defects- a combination of loss in both
dimensions
• Class O – no defect
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Class III defect
Class O defect
19. Surgical corrections of ridge defects
• Roll technique
• Pouch technique
Class I defect
• Inter positional
graft
• Onlay graft
Class II & III
defect
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Pontics in FPD- 84
27. Pontic modifications
1. Patient’s inability to undergo surgery because of
cost.
2. Patient’s with medically compromised condition.
3. Ridges with severe defects, where 2 or more pontics
must be used to fill the space.
• By means of
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Pontics in FPD- 84
1. Gingival masks
2. Andrews bridge system
28. 11/11/2022 28
Pontics in FPD- 84
Gingival masks
• Edelhoff D,. A review of esthetic pontic design options.
Quintessence ini 2002:33:736-746.
Indication
30. Principles of pontic design
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Biological
Esthetic
Mechanical
31. Biologic principles of pontic design pertain to the
maintenance and preservation of
Residual ridge
Abutment & opposing teeth
Supporting tissues
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Pontics in FPD- 84
Biologic principles
33. Pontic ridge contact
Contact only facial to
the crest of the ridge
Tip of pontic must restricted
to keratinized gingiva
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Pontics in FPD- 84
34. 11/11/2022 34
Pontics in FPD- 84
Reduced keratinisation
Ulceration
Cavazos E . Tissue response to fixed partial denture pontics. J prosthet dent
1968;20(2): 143-153.
35. 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.
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36. 11/11/2022 Pontics in FPD- 84 36
Sten RS in JPD 1958
“for a patient to maintain good oral hygiene to
prevent formation of plaques and to enjoy the
assurance of longevity of post dental restoration”
37. Biological aspect of Pontic material
• Any material chosen to fabricate the pontic should provide
• Glazed porcelain is generally considered the most
biocompatible of the available pontic. Well polished gold
is smoother, less prone to corrosion, and less retentive of
plaque than an unpolished or porous casting.
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Pontics in FPD- 84
38. Clayton JA in JPD 1970
• Concluded that test surfaces of glazed porcelain
were significantly rougher than polished test
surfaces of either acrylic resin or cast gold
Behrend DA in JPD 1981 & Henry PJ in JPD
1966
• Stated that glazed porcelain was most hygienic
material used and it is superior in terms of
esthetics and cleaning
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39. Occlusal forces
• Potentially harmful forces are more likely to
encounter if an FPD is loaded by an accidental biting
on a hard object or para functional activities like
bruxism.
• These forces are not reduced by narrowing the
occlusal table
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40. Mechanical problems may be caused by
• These factors can lead to fracture of the prosthesis
or displacement of the retainers.
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Mechanical principles
41. • Long-span posterior FPDs are particularly susceptible
to mechanical problems.
• Fracture of a long span metal ceramic FPD due to
high stress.
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42. Mechanical aspect of pontic materials
• Some fixed partial dentures are fabricated entirely of
• Acrylic resin veneered pontics have had limited
acceptance because of their reduced durability (wear
and discoloration).
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43. Metal ceramic pontics
• A well fabricated metal-ceramic
pontic is strong, easy to keep clean,
and looks natural.
• Mechanical failures are
Excessive thickness of porcelain
contributes to inadequate support
and predispose to fracture.
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44. • The metal surfaces to be veneered must be smooth
and free of pits. This leads to voids at interface.
• Sharp angles on the veneering area should be
rounded. They produce increased stress
concentrations that can cause mechanical failure.
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45. Resin-veneered pontic
• Historically, acrylic resin-veneered restorations had
deficiencies that made them acceptable only as
longer term provisional's.
• Their resistance to abrasion was lower then enamel
or porcelain, and noticeable wear occurred with
normal tooth-brushing.
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46. Fiber reinforced composite resin
pontics
• Composite resin can be used in FPD without a metal
substructure.
• A substructure matrix of impregnated glass or
polymer fiber provides structural strength.
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47. • An esthetically successful pontic should replicate
The form,
Contours,
Incisal edge,
Gingival and incisal embrasures,
Color of adjacent teeth.
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Esthetic Considerations
48. • A pontic should be interpreted as "growing" out of
the gingival tissue.
• Modified ridge lap pontic is recommended in anterior
situations.
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51. Mesiodistal width
• Frequently, the space available for a pontic will be
greater or smaller than the width of the contra
lateral tooth.
• This is usually due to uncontrolled tooth movement
that occurred when a tooth was removed and not
replaced.
• If possible, such a discrepancy should be corrected
by orthodontic treatment.
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52. • The width of an anterior tooth is usually identified by
the relative positions of the mesiofacial and
distofacial line angles.
• 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.
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53. • Space discrepancy presents less
of a problem when posterior
teeth are being replaced because
their distal halves are not
normally visible from the front.
• A discrepancy here can be
managed by duplicating the
visible mesial half of the tooth
and adjusting the size of the
distal half.
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54. 11/11/2022 Pontics in FPD- 84 54
Edelhoff, spiekermann and yildirim in
Quintessence Int 2002
• Pontic design is primarily influenced by
esthetic and phonetic considerations
• Local defects of the alveolar ridge often
complicate restorative measures
• They advocated modification of the pontic
design and pretreatment of the recipient site
for the pontic
55. Specifications for pontic design
• All surfaces should be smooth and convex
and properly finished .
• Contact with the labial mucosa should be
minimal and pressure free.
• Esthetics may require a long area of
contact to prevent the “black space
appearance”.
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Anterior pontic design
56. Posterior pontic design
• All surfaces should be convex and properly finish.
• Contact with buccal contagious slope should be
minimal and pressure free.
• Buccal and lingual shunting mechanism should
confirm to that of adjacent teeth.
• The occlusal table must be in functional harmony
with the occlusion of all the teeth.
• The overall length of the buccal surface should be
equal to that of the adjacent abutment teeth.
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58. According to Tylman’s
Pontics
Shape of the surface
contacting the ridge
Spheriodal
Conical
Ride lap
Modified
ridge lap
Materials used in
constructing a pontic
All metal
Metal
porcelains
Combination of
metal and resins
Pontics prefabricated by
manufracture
Flat backs
Trupontics
Long-pin pontics
Pontips
Reverse pin facings
Custom made
pontics
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Pontics in FPD- 84
60. According to Shillingburg
• Based on pontic design
• Saddle (ridge lap)
• Modified ridge lap
• Hygienic
• Conical
• Ovate
• Prefabricated pontic facings
• Metal-ceramic pontics
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61. According to Rosenstiel
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Pontics in FPD- 84
MUCOSAL CONTACT
Ridge lap
Modified Ridge lap
Ovate
Conical
NO MUCOSAL CONTACT
Sanitary
Modified sanitary
62. 11/11/2022 Pontics in FPD- 84 62
Description of individual pontics
according to Rosenstiel
63. SADDLE or RIDGE LAP PONTIC
• The saddle pontic has a concave fitting surface that
overlaps the residual ridge buccolingually, simulating
the contours and emergence profile of the missing
tooth on both sides of the residual ridge.
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Pontics in FPD- 84
ulceration
64. MODIFIED RIDGE LAP PONTIC
• The modified ridge lap pontic combines the best
features of the hygienic and saddle pontic designs,
combining esthetics with easy cleaning.
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Cross section
65. CONICAL PONTIC
• Often called egg-shaped, bullet-shaped, or heart-
shaped, the conical pontic is easy for the patient to
keep clean.
• It should be made as convex as possible, with only one
point of contact at the center of the residual ridge.
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66. OVATE PONTIC
• Developed by ABRAM in 1980
• The ovate pontic is the most esthetically appealing
pontic design, because it emerge from gingiva.
• It requires faciolingual width and apicocoronal thickness.
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67. MODIFIED OVATE PONTIC
• Developed to circumvent the problems encountered
with ovate Pontic by Liu 2003
• It does not require as much faciolingual thickness to
create an emergence profile .
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68. SANITARY OR HYGIENIC PONTIC
• Sanitary pontic allows easy cleaning, because its
tissue surface remains clear of the residual ridge.
• It’s disadvantages include entrapment of food
particles, which may lead to tongue habits that may
annoy the patient and less esthetic.
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69. MODIFIED SANITARY PONTIC
• Its gingival portion is shaped like an archway between
the retainers.
• 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.
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71. SPLIT PONTIC TECHNIQUE
• It is an attachment placed entirely
within pontic.
• Use with tilted abutments to avoid
cutting deep box on distal of mesial
retainer.
• Plastic key or keyway is placed in
gingival third of pontic using surveyor.
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Pontics in FPD- 84
Shillingburg TH et al.,: Fundamentals of fixed prosthodontics, 3rd
ed. Carol Stream, Quintessence, 1997, pp. 531-532.
72. MULTIPLE HYGIENIC PONTIC
• This design is particularly well suited for long-
span FPDs because the metal casting is
extremely rigid.
• Mandibular anterior region.
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Pontics in FPD- 84
Zuckarman GR. A hygienic multiple pontic design.
Quint. Int 1997;28(4):259-262.
73. Features of multiple hygienic pontic
• Incompletely developed labiogingival
embrasures between adjacent pontics.
• Elimination of the linguiogingival
embrasures between adjacent pontics.
• Wide embrasures between the pontics
and the retainers.
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Pontics in FPD- 84
74. FREE-END PONTICS USED ON FPD
• The most typical free-end pontic on fixed partial dentures is a
single pontic attached to a single abutment casting.
• For example, a missing upper lateral incisor is restored with the
cuspid as the abutment tooth, by soldering the lateral incisor
pontic to the cuspid with no direct attachment on its mesial
surface.
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Schweitzer JM, Schweitzer RD, Schweitzer J. Free end pontics used on fixed
partial denture. J Prosthet Dent 1968;20(2):120-138
75. BONDED PONTICS
• The earliest resin bonded prosthesis were extracted
natural teeth or acrylic teeth used as pontics bonded
to the proximal and lingual surfaces of abutment
teeth with composite resins.
• Cast perforated resin
retained FPD s (mechanical)
- Rochette
11/11/2022 Pontics in FPD- 84 75
76. • Etched cast retained FPD s (micro mechanical) -
Maryland
• Macroscopic mechanical retention resin retained FPD s
– Virginia.
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77. USE OF NATURAL TOOTH AS A PONTIC
• Using the natural tooth as a pontic offers the
benefits of being the right size, shape and colour.
Moreover, the positive psychological value to the
patient in using his or her natural tooth is an added
benefit.
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Kukreja BJ, Kukreja P. Use of Natural Tooth as a Pontic . Clinical Dentistry 2012;44-49
79. FIBER REINFORCED COMPOSITE RESIN
PONTICS
• Drawbacks of metal substructure used for metal
ceramic
1. Undergo corrosion and may elicit allergic
reactions.
2. Causes acute or chronic hazard to laboratory
personnel.
3. Lack of esthetic
11/11/2022 Pontics in FPD- 84 79
80. • Composite resin can be used in
FPD without a metal
substructure.
• A substructure matrix of
impregnated glass or polymer
fiber provides structural strength.
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81. Post Operative Care
• Patient should be instructed to use oral hygiene aids such as
floss threads and brushes around pontic.
• Floss can be looped throw the embrasures spaces on each
sides, and loop can be pulled tightly the convex pontic
surface.
• A slide motion is then used to remove plaque.
• Periodic recall check up
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Pontics in FPD- 84
84. References
• Rosenstiel FS, Land FM, Fujimoto J: Contemporary fixed
prosthodontics, 4th ed. St. Louis, Elsevier,2011, pp.616-648.
• Shillingburg TH et al.,: Fundamentals of fixed prosthodontics,
3rd ed. Carol Stream, Quintessence, 1997, pp. 485-507.
• Malone FP et al.,: Tylman’s theory and practice of fixed
prosthodontics, 8th ed. St. Louis, Ishiyaku EuroAmerica, 1997,
pp. 375-370.
• Bernard GN Smith.Planning and making Crowns and Bridges,
3rd ed. London, Martin Dunitz, 2000, pp. 41-61,215-222.
11/11/2022 Pontics in FPD- 84 84
85. • Edelhoff D,. A review of esthetic pontic design options.
Quintessence ini 2002:33:736-746.
• Cavazos E . Tissue response to fixed partial denture pontics. J
prosthet dent 1968;20(2): 143-153.
• Stein RS. Pontic residual ridge relationship: A research. J
Prosthet Dent 1966;16:251.
• Schweitzer JM, Schweitzer RD, Schweitzer J. Free end pontics
used on fixed partial denture. J Prosthet Dent
1968;20(2):120-138
11/11/2022 Pontics in FPD- 84 85
References
86. • Zuckarman GR. A hygienic multiple pontic design. Quint. Int
1997;28(4):259-262.
• Kukreja BJ, Kukreja P. Use of Natural Tooth as a Pontic .
Clinical Dentistry 2012;44-49
11/11/2022 Pontics in FPD- 84 86
References
Editor's Notes
Way to assess clinical intraoral examination, diagnostic cast and mounting, radiographs
For esthetic and health of tissue.
Wedge shaped graft
Cut residual ridge for revascularization
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.
Prepare the abutment teeth
Prepare the interim FPD indirect technique
Preserve facial plate of the bone and scalloped architecture of the interproximal bone, it is essential for preservation of interdental pabilla
After extraction pontic should be ovate 2.5 mm apical to facial free gingival margine. Because scoket begin to collapse immeiatly of the extraction.
Light force used to extrude the tooth to be extraction, leads to apposition of bone occur.
Red line reference point. Blue and yellow line denotes change in gingival crest height
Small defect treated with pink porcelain
Large defect treated with Andrews bridge
Black trianges collect plaque, interfere with floss, reduce rigidity of pontic span
It should support with metal frame work otherv wise leads to fracture
Fixed retainers are connected by rectangular bar ,
Slightly wider mesiodistally at facial and narrow at lingual aspect and the contact should not gingivofacial line angle
FPDs should be made as rigid as possible, because any flexure during mastication or Para function may cause pressure on the gingiva and cause fractures of the veneering material.
Narrowing the occlusal table may impede or even preclude the development of harmonious and stable occlusal relationship.
Most pontics are fabricated by the metal-ceramic technique.
1 The framework must provide a uniform veneer of porcelain (approximately 1.2mm).
Surface irregularities will cause incomplete wetting by the porcelain slurry, leading to voids at the porcelain metal interface that reduce bond strength and increase the possibility of mechanical failure.
Continuous dimensional change of the veneers often caused leakage at the metal-resin interface, with subsequent discoloration of the restoration.
The pontics simulation of a natural tooth is most often betrayed at the tissue-pontic interface.
A, A pontic should have the same incisogingival height (H) as the original tooth. B, Correctly contoured pontic. C, Incorrect contour. (The dotted lines in B and C show the original tooth contour.) The shelf at the gingival margin may trap food and create an esthetically unacceptable shadow.
Uncontrolled tooth movement leads to lack of space it should be correct by orthodontic corrections.
Not indicated because it causes ulceration and difficult to clean.
Advantage is esthetic
Disadvantage -Less esthetic
This design is recommended for mandibular posterior teeth where esthetics is a lesser concern.
Advantage is pleasing appearance and strength. Extraction socket
Its major disadvantage is that it requires a sufficient faciolingual width and apicocoronal thickness to house the ovate pontic within the edentulous ridge. Otherwise it require augmentation procedures.
Ease to clean than ovate
Strong cuspid with lateral pontic, weakest lateral supporting central pontic
There are certain advantages to using polymeric materials instead of ceramics.
They are easy to manipulate and repair and do not require the high melting range alloys needed for metal-ceramic techniques.
New generation indirect resin have a higher density of inorganic ceramic filler than traditional direct and indirect composite resin.
Economic of pt.
Missing 31 modified ridge lap pontic is given for the natural teeth then tooth is articulated and bonded to the fiber splint then it is bonded with light cure composite.
Immediate pontic technique’ suggested by Spear maintains the interdental papilla following anterior tooth removal.
The pontic design is said to determine the success or failure of a bridge. 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.
