FPD - Pontics

1. INTRODUCTION
 The restorations of edentulous areas with fixed partial dentures (FPDs) present a
particular challenge for the clinician.
 Because of their ease of use and favorable long term results, conventional FPDs
represent the most popular treatment measure today.
 In these restorations, the pontic must fulfill the complex roles of replacing the
function of the lost tooth, achieving an esthetic appearance, enabling adequate
oral hygiene, and preventing tissue irritation.

2. PONTICS IN FPD
Dr Varsha Gupta
2nd MDS,Prosthodontics

3. CONTENT
 Introduction
 Definition
 Pretreatment assessment
pontic space
residual ridge contour
surgical modification
gingival architecture preservation
 Classification of pontics
 Biologic considerations
 Mechanical considerations
 Esthetic considerations
 Cross references
 References

4. HISTORY
 Egyptians and Phoeniceans were the pioneers in the field of pontics and were
the first to construct dental bridge work. These were mostly made of calf bone
or ivory.
 It was Mancy in 1928 who laid the foundation to present day FPD design,
however
 Pierre Fauchard (1923) has often been referred to as the ‘Father of Modern
Dental Prosthesis’.
 In his work in the field of FPD he used what he called ‘tenons’ which were in
reality dowels or pivots screwed into the roots to retain some of the bridges.

5. DEFINITION
 GPT 9 - pontic pŏn΄tĭk n: an artificial tooth on a fixed partial denture
that replaces a missing natural tooth, restores its function, and usually
restores the space previously occupied by the clinical crown.
 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.
 ROSENSTIEL defines pontic as “the artificial teeth of a fixed partial dental
prosthesis that replaces the missing natural teeth, restoring function and
appearance.”

6. FUNCTIONS

7. PRETREATMENT
ASSESSMENT

9. 2)Residual ridge contour
Loss of ridge contour

10. SIEBERT’S CLASSIFICATION OF RESIDUAL
RIDGE DEFORMITIES:

12. GINGIVAL ARCHITECTURE
PRESERVATION

14. PONTIC SELECTION
Surfaces-
convex,smooth,properly
finished
Contact-labially (pin
pontic) and
pressure free(lap facing)
Lingually(harmony with
adjacent teeth or pontics
Anterior region
Pontic- residual ridge relationship: A research report.
Stein RS, J Prosthet Dent 1966; 16: 251

15. Pontic- residual ridge relationship: A research report. Stein RS, J Prosthet Dent 1966; 16: 251
Occlusal table (harmony)
Buccal and lingual
shunting mechanism-
adjacent teeth
overall length of buccal
surface =adjacent
abutments or pontics
Posterior region

16. 1. Depending on shape of surface
contacting the ridge(Tylman)
Sanitary
Modifiedsanitary
Spheroidal
Saddle/Ridge lap
Modified ridgelap
Ovate
CLASSIFICATION
•Based on mtaerials used
•Metal and porcelain
veneered
•Metal and resin
veneered
•All metal pontic
•All ceramic pontic

17. Custom made
pontic
4.METHOD OF FABRCIATION

18. According to Oswal :
Ÿ Conventional –
commonly used pontic designs are ridge lap
pontic, modified ridge lap pontic, sanitary, conical and ovate
pontic.
Ÿ Unconventional –
modified ovate, modified sanitary pontic,
occlusal bar, Stein pontic, spheroidal, hollow, inzoma, split
pontic, cross pin and wing

19. • Zero tissue contact
• Occlusalgingival thickness should be atleast 3mm &
Convex mesiodistally and faciolingually
• Space beneath the pontic – 2mm ( Rosenstiel)
- 3 mm ( Tylman)
SANITARY OR HYGIENIC PONTIC OR FISH BELLY

20. 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
MODIFIED SANITARY
PONTIC/PEREL/ARC FIXED:-

21. A modified sanitary pontic

22. SADDLE OR RIDGE LAP PONTIC
The concave gingival surface of
the pontic is not accessible to
cleaning with dental floss-
plaque accumulation-
tissue inflammation

23. MODIFIED RIDGE LAP
The modified ridge lap pontic combines
the best features of the hygienic and
saddle pontic designs, combining esthetics
with easy cleaning

24. Tissue contact should resemble a letter T whose vertical arm ends
at the crest of the ridge.
maxillary and mandibular anterior teeth
&
maxillary premolars and first molars

25. egg-shaped, bullet-shaped, or
heart-shaped
recommended for the replacement
of mandibular posterior teeth
where esthetics is a lesser concern.
CONICAL PONTIC

26. A knife-edged residual ridge will
necessitate flatter contours with a narrow
tissue contact area.
This type of design may be unsuitable for
broad residual ridges, because the
emergence profile associated with the small
tissue contact point may create areas of
food entrapment.

27. 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
OVATE PONTIC

28. • Socket-preservation techniques should
be performed at the time of extraction to
create the tissue recess from which the
ovate pontic form will emerge
• Contour of provisional is important

29. • The modification of the ovate pontic involves moving he height of contour
at the tissue surface from the center of the base to a more labial position.
MODIFIED OVATE PONTIC
Unconventional pontics in Fixed Partial Dentures Mansi Manish Oswal, Manish Sohan

30. PREFABRICATED PONTICS
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
Indication: Reduced interarch distance

31. 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

32. The major disadvantage:
of this system is its
complex design, which
leads to accumulation of
plaque and gingival
inflammation.

33. c) Sanitary facing –flat occlusal surface and a
slot on the proximal surface to fit into the metal
projections made in the FDP
Pin facing – A flat lingualfacing with two
horizontal pins for retention.
Reduced occlusogingival height.

34. e) Modified Pin Facing
Facing is modified by adding porcelain to
lingual gingival area of a pin facing
f)Reverse pin facing –
Porcelain is added to the gingival end of the facing and
multiple precision pin holes are drilled into the lingual
surface
indicated -deep overbite where short pins are required

35. g. Harmony facing –
This facing is supplied with an uncontoured
porcelain gingival surface and usually two
retentive pins on the flat lingual side.
h. Porcelain fused to metal
facing Facing consists of a metal
core over which porcelain is fused.

36. i. Pontips:
These facings are used when the
tissue contact of the ponic should of
glazed porcelain
Convex gingival surface having
pinpoint tissue contact and
Attached to the backing occlusally with
retentive pins

38. BIOLOGICAL CONSIDERATIONS
Factors of specific influence are:

39. Pressure free contact between the pontic and the underlying tissue
is indicated to prevented ulceration and inflammation of the soft
tissues.
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.
RIDGE CONTACT

40. Pontic-residualridgerelationship:Aresearch report
SteinRS,JProsthetDent1966;16:251
.
• AIM: 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.

41. • 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.

42. Cavozos E : Tissue response to fixed partial denture pontics. J Prosthet
Dent 1968; 20: 143
A study to demonstrate that the adaptations of
pontic to the ridge or the amount of “relief” on the
cast is highly significant and directly proportional to
the amount of unfavourable tissue change.
Absolute minimal (0.0 to 0.25mm of cast
scraping) produced no tissue changes.
When the cast scraping was increased to 1mm, tissue
changes were produced varying from mild
inflammation to ac8
u1
teulceration

43. NOTE:

44. Devices such as proxy brushes, pipe
cleaners, Oral-B Super Floss, and
dental floss with a threader are highly
recommended
Gingival embrasures around the pontic
should be wide enough to permit oral
hygiene aids.

45. 1. Should provide good esthetic results, biocompatibility, rigidity,and
strength to withstand occlusal forces; and longevity.
2. Occlusal contacts should not fall on the junction between metal and
porcelain during centric or eccentric tooth contacts,
1. Investigations into the biocompatibility of materials used
to fabricate pontics have centered on two factors :
2. The effect of the materials and
3. The effects of surface adherence.
PONTIC MATERIAL

46. • 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.
Scanning electron
micrographs of glazed
porcelain (A), polished gold
(B), and polished acrylic
resin (C).

48.  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.
OCCLUSAL FORCES

49.  Narrowing the occlusal table may actually impede the development
of a harmonious and stable occlusal relationship
 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

50. MECHANICAL
CONSIDERATIONS
Mechanical problems may be caused by
improper choice of materials
poor frame work design
poor tooth preparation
poor occlusion.

51. 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.
METAL CERAMIC PONTICS

52. Occlusal centric contacts must be placed at
least 1.5 mm away from the metal-porcelain
junction

53. 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 .

54. 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
RESIN VENEERED PONTICS

55. A substructure matrix of impregnated
glass or polymer fiber provides structural
strength.
Excellent marginal adaptation and esthetics
FIBER-REINFORCED COMPOSITE
RESIN PONTICS

56. SUMMARRY

57.  No matter how well biologic and mechanical principles have been
followed during fabrication, the patient will evaluate the result by
how it looks, especially when anterior teeth have been replaced
ESTHETIC
CONSIDERATIONS

58. • 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 itapproaches the pontic-tissue junction to achieve
a “natural appearance.”
GINGIVAL INTERFACE

59. • 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.

60. 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

61. • 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
INCISOGINGIVAL LENGTH

62. 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.

63. • 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
MESIODISTAL WIDTH

64. • The width of an anterior tooth is usually identified by the relative
positions of the mesiofacial and distofacial line angles, and the
overall shape by the detailed pattern of surface contour and light
reflection between these line angles

65. • 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.
H Spiekermann: A review of esthetic pontic design options. Quintessence Int 2002;33:736-746
GINGIVA COLOURED CERAMICS

66. This method is particularly suitable for patiens
with a local alveolar ridge defect that has not
been corrected by augmentation of the soft
tissue.
D
8a
1n
ie
lE , H Spiekermann: A review of esthetic pontic design options. Quintessence Int
2002;33:736-746
ALL CERAMIC GINGIVAL MASKS

67. 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.
(This is another situations in which a
diagnostic waxing procedure will help solve
a challenging restorative problem).

68. Discrepancy here can be managed by
duplicating the visible mesial half of
the tooth and adjusting the size of the
distal half.
Space discrepancy presents less of a
problem when posterior teeth are
being replaced because their distal
halves are not normally visible from
the front.

69. Connector in a fixed partial denture can
be defined as,"The portion of a fixed partial
denture that unites the retainer(s) and
pontic(s)"—GPT.
Classified as – RIGID
NON RIGID

70. RIGID-These connectors are used when the
entire load on the pontic is to be
transferred directly to the abutments
NON RIGID-These connectors are indicated
in cases where a single path of insertion
cannot be achieved due non-parallel
abutments.

71. Tenon Mortise Connectors (TMC) with a male and female
component or dovetail connectors

72. LOOP CONNECTIRS
Loop connectors are used when an existing
diastema is to be maintained in a planned
fixed prosthesis.The connector consists of a
loop on the lingual aspect of the prosthesis
that connects adjacent retainers and/or
pontics

73. SPLIT PONTIC CONNECTOR :
They are used only in cases with a pier abutment.
Here the connector is incorporated within the pontic.
The pontic is split into mesial and distal segments.

74. CROSS PIN AND WING

75. PONTIC FABRICATION
Most pontics are now made with the metal-ceramic technique,
which provides the best solutionto the biologic, mechanical, and
esthetic challenges encountered in pontic design.
Their fabrication,however, differs slightly from the fabrication of in-
dividual crowns. These differences will be empha-
sized in the ensuing paragraphs.

76. For strength andesthetics, an accurately controlled
thickness of porcelain is needed in the finished
restoration.
To ensure this, a wax pattern is made to the final
anatomic contour.

77. 1.Wax the internal, proximal, and axial surfaces
of the retainers
2. Soften the inlay wax, mold it to the approxi-
mate desired pontic shape, and adapt it to the ridge. This is the
starting point for subse-quent modification.
3.Lute the pontic to the retainers and, for addi-tional stability, connect
its cervical aspect di-rectly to the master cast with sticky wax.
Then wax the pontic to proper axial and oc-
clusal (or incisal) contour (Fig. 20-44).
5. Complete the retainers and contour the prox-imal and tissue
surfaces of the pontic for the desired tissue contact.
6. The pontic is now ready for evaluation before cut-back.
STEPS

78. STEPS FOR
CUT BACK
1.Use a sharp explorer to outline the area that will be veneered
with porcelain .
The porcelain-metal junction must be placed suf-ficiently lingual
to ensure good esthetics,section one connector
2.Finish the cut-back of this retainer, making sure there is a
distinct 90-degree porcelain-metal junction.
3.Reflow and finalize the margins. The ponticis held in position
by the other retainer dur-ing this procedure.
4. Refine the pontic cut-back where access is im-proved by
removal of the first retainer.
5. Reseat the first retainer, reattach it to the pon-tic, section the
other connector, and repeat the process.

79. 6. Sprue the units and do any final reshaping as
needed and casting is carried out.
• Recover the castings
• Finish the gingival surface of the pontic. Do not
overreduce this area.

80. 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 were fabricated.
Fibre reinforced composite fixed dental prosthesis with
various pontics Leila perera et al

81. 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).

82. CONCLUSION:
By increasing the occlusal thickness of the
pontic, the load- bearing 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.

83. Enhancing Esthetics with aFixed Prosthesis Utilizing an
Innovative Pontic Design and Periodontal Plastic Surgery
Journal of Esthetic and Restorative Dentistry, 2014
This article addresses how to reestablish or maintain papilla height and the
facial gingival tissue between a single or multiple missing teeth adjacent to a
natural tooth or an implant by using a pontic design termed the E-pontic
Limitations: when there is an alveolar ridge defect with apico-coronal loss of
tissue and/or a combination of buccolingual and apico-coronal loss of tissue
At least 2 mm of soft tissue over the
alveolar bone is necessary to create the
site;
3–5 mm of soft tissue coverage is ideal

85. PREFABRICATED WAX PONTICS
Advantages:
* Without collar
* Reduced occlusal depths
*Perfect scraping and modelling
characteristics
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

86. • 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
CONCLUSION

87. 1. Rosenstiel S F et al : Contemporary Fixed Prosthodontics, 4th edn
Missouri, Mosby Inc, pg 513
2. Shillingburg H T et al : Fundamentals of fixed prosthodontics,
ed 4, Chicago , Quintessence Publishing,
pg 485
3. Tylman SMalone W. Tylman's Theory and practice of fixed
prosthodontics. 8th ed.
4. The Glossary of Prosthodontic Terms. The Journal of Prosthetic
Dentistry. 2005;94(1):10-92.
5. Cavozos E : Tissue response to fixed partial denture pontics. J Prosthet
Dent 1968; 20: 143
6. Daniel Edelhoff, H Spiekermann: A review of esthetic pontic design
options. Quintessence Int 2002;33:736-746
7. Henry P J et al: Tissue changes beneath fixed partial
dentures. J Prosthet Dent 1966; 16: 937
REFERENCES

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8. Stein RS: Pontic- residual ridge relationship: A research report. J
Prosthet Dent 1966; 16: 251
9. 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.
10. Fiber-reinforced Composite Fixed Dental Prostheses with Various
Pontics The Journal of Adhesive Dentistry2014Vol 16, No 2
11. Kim T, Cascione D, Knezevic A. Simulated tissue using a unique pontic
design: A clinical report. The Journal of ProstheticDentistry.
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89. THANK YOU