Pontics and Retainers

Pontics and retainers

1. Pontics and retainers

2. Pontics are the artificial teeth of a fixed partial denture that replace missing natural teeth, restoring function and appearance.

3. They must be compatible with continued oral health and comfort.

4. Pontics are classified according to the shape of the gingival side of the pontic

5. Pontic design classification Mucosal contact Saddle or ridge lap Modified ridge lap Conical ovate No mucosal contact Sanitary (hygienic) Modified sanitary(hygienic

6. Saddle or ridge lap

7. Saddle or ridge lap The saddle pontic has a concave fitting surface that overlaps the residual ridge buccolingually , simulating the contours and emergence profiles of the missing tooth on both sides of the residual ridge.

8. should be avoided, because the concave gingival surface of the pontic is not accessible to cleaning with dental floss, which will lead to plaque accumulation.

9. 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

10. design overlaps the residual ridge on the facial ( to achieve the appearance of a tooth emerging from the gingiva ) but remains clear of the ridge on the lingual .

11. To enable the optimal plaque control, the gingival surface -Should be as convex as possible from mesial to distal -must have no depression or hollow

12. Tissue contact should resemble a letter T, whose vertical arms ends at the crest of the ridge.

13. Facial ridge adaption is essential for a natural appearance

14. used in areas of the mouth that are visible during function (maxillary and mandibular anterior teeth and maxillary premolars and first molars).

15. CONICAL PONTIC Often called egg-shaped, bullet-shaped, or heart-shaped Easy for the patient to keep clean

16. It should be made as convex as possible, 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

17. 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.

18. This type of design may be unsuitable for broad residual ridges, because it may create food entrapment.

19. OVATE PONTIC the most esthetically appealing pontic design. Its convex tissue surface resides in a soft tissue depression or hollow in the residual ridge, it appear that a tooth is literally emerging from the gingiva

20. Socket-preservation techniques should be performed at the time of extraction to create the tissue recession.

21. For a preexisting residual ridge, soft tissue surgical augmentation is typically required

22. SANITARY OR HYGIENIC PONTIC the design feature of the sanitary pontic allows easy cleaning, because its tissue surface remains clear of the residual ridge

23. Modified sanitary Its gingival portion is shaped like an archway between the retainers.

24. permits increased connector size Decrease the stress concentrated in the pontic and connectors

25. indications Posterior mandible Impaired oral hygiene

26. Requirements Biologic Mechanical esthetic

27. Biologic requirements It must have Cleansable tissue surface Access to abutment tooth No pressure on ridge

28. Pertain to the maintenance and preservation of residual ridge, abutment teeth and supporting tissues.

29. 1. ridge contact Pressure free contact between the pontic and the underlying tissues is indicated to prevent ulceration and inflammation of the soft tissues.

30. When a pontic rest on mucosa, some ulerations may appear as a result of the normal movement of the mucosa. So if any blenching of the soft tissue is observed at try-in, the pontic should be recontoured until the tissue contact is entirely passive.

31. 2.Oral hygiene consideration Patient must be taught efficient oral hygiene techniques. Gingival embrasures around the pontic should be wide enough to permit oral hygiene aids, but should not be opened excessively, to prevent food entrapment.

32. Ridge irritation is mainly caused by toxins released from the bacterial plaque, accumulate between the gingival surface of the pontic and ridge, causing tissue inflammation and calculus formation.

33. If the pontic has a depression or concavity in its gingival surface, plaque and tissue inflammation will occur.

34. 3.Pontic material Glaced poreclain is generally considered the most biocompatible. Well -polished gold is smoother, less prone to corrosion, and less retentive of plaque than an unpolished or porous casting.

35. ceramic tissue contact may be contraindicated in edentulous areas where there is minimal distance between the residual ridge and the occlusal table. In these instances, placing ceramic on the tissue side of the pontic may weaken the design of the metal substructure, particularly with porcelain occlusal surface.

36. 4. Occlusal force Reducing the buccolingual width of the pontic has been suggested as a way to lessen occlusal forces

37. Mechanical requirements Be rigid to resist deformation Have strong connectors to prevent fracture Have a metal-ceramic framework to resist porcelain fracture

38. Mechanical problems may be caused by improper choice of materials, poor framework design, poor tooth preparation, or poor occlusion.

39. The material chosen to fabricate should be as rigid as possible, because any flexure during mastication or parafunction may cause pressure on the gingiva and cause fractures of the veneering material.

40. Long-span posterior FPDs are particularly susceptible to mechanical problems, due to the significant flexing from high occlusal forces.

41. Available pontic materials Metal-ceramic pontics Resin-veneered pontics Fiber-reinforced Composite Resin pontics

42. Esthetic requirements Be shaped to look like tooth it replaces Appear to grow out of edentulous ridge Have sufficient space for poreclain

43. An aesthetically 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.

44. retainers It is a fixed restoration, usually in the form of crown, cemented to the prepared abutment tooth, to provide stabilization for the bridge,(FPD).

45. Retainers A. Posterior Region Major Retainers Full crown ¾ Crown Minor Retainers Class II Inlay

46. B. Anterior Region Major Retainer Full Crown ¾ Crown Post Crown Minor Retainer Cl III Inlay

47. According to the retention, retainers are classified as Extra coronal retainers Intracoronal retainers Intra radicular retainers

48. Extracoronal retainers Full coverage 1.full metal crown 2.metal ceramic crown 3.jacket crown 4.telescopic crown

49. Partial coverage crown 1. ¾ crown 2.reversed 3/4crown, 3. half crown 3. 7/8 crown

50. intracoronal Inlay(MOD Inlay is commonly used) onlay

51. intra- radicular retainers cast post Prefabricated post

52. Selection criteria Full veneer crown-abutment teeth are aligned parallel to each other. Partial veneer-non carious abutment

53. connectors the portion of a fixed partial denture that unites the retainer and pontic

54. connectors Classification Rigid connector cast connector soldered connector semi-rigid connector -interlocks custom made 3. Loop or a spring type