PONTICS IN FIXED PARTIAL DENTURE FOR ORAL

Pontic in fixed partial denture

1. PONTICS IN FIXED PARTIAL
DENTURE
1
PRESENTED BY
DR RENUKA DANGE

2. CONTENTS
2
INTRODUCTION
DEFINITION
PRETREATMENTASSESSMENT
PONTICSPACE
RESIDUALRIDGECONTOUR
SURGICALMODIFICATION
GINGIVALARCHITECTUREPRESERVATION
CLASSIFICATIONOFPONTICS
BIOLOGICCONSIDERATIONS
MECHANICALCONSIDERATIONS
ESTHETICCONSIDERATIONS
CROSSREFERENCES
REFERENCES

3. •Estheticappearance
•Enablingadequateoralhygiene
•Preventingtissueirritation
3
INTRODUCTION

4. ACCORDINGTO:
GPT-8
Anartificialtoothonafixeddentalprosthesisthatreplacesamissing
naturaltooth,restoresitsfunction,andusuallyfillsthespace
previouslyoccupiedbytheclinicalcrown.
TYLMAN
thesuspendedmemberofafixedpartialdenturewhichreplacesthe
lostnaturaltooth,restoresfunctionandoccupiesthespaceofthe
missingtooth.
4
DEFINITION
.
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.
1

5. OPTIMALPONTIC DESIGN
5

6. PRETREATMENT ASSESSMENT
6
I] PONTIC SPACE:
One function of FPD is to prevent tilting or drifting of the
adjacent teeth into the edentulous space.
Drifting / tilting
Reduced ponticspace
Difficulty in fabricating pontic

7. ESTHETIC ZONE
•Orthodontic alignment
•Abutment modification with
complete coverage retainers
NONESTHETIC ZONE
•Overly small pontics are
unacceptable
•Trap food
•Difficult to clean•Careful diagnostic waxing to
determine most appropriate
treatment
7
81

8. 2) RESIDUAL RIDGE CONTOUR
8
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

9. LOSSOFRESIDUALRIDGECONTOUR:
Unestheticopengingivalembrasures“BLACK
TRIANGLES”
Foodimpaction
Percolationofsalivaduringspeech
9
81

10. 10
SIEBERT’S CLASSIFICATION OF RESIDUAL RIDGE DEFORMITIES :
ClassIdefects
Faciolinguallossof
tissuewidthwith
normalridgeheight.
ClassIIdefects
Lossofridgeheight
withnormalridge
width.
ClassIIIdefects
acombinationoflossin
bothdimensions.

11. CLASSIFICATION
1.Depending on shape of surface
contacting the ridge(Tylman)
 Sanitary
Modified sanitary
Spheroidal
Saddle
Ridge lap
Modified ridgelap
Ovate
2.According To Rosenstiel
Depending On Mucosal Contact
A. Mucosal contact
Ridge Lap
Modified Ridge Lap
Ovate
Conical
B. No Mucosal Contact
Sanitary(hygenic)
Modified Sanitary
3. Based on materials used
•Metal and porcelain veneered
•Metal and resin veneered
•All metal pontic
•All ceramic pontic

12. 4. METHOD OF FABRICATION:
•Custom made pontic
12

13. Pontic selection depends primarily on esthetics and oral hygiene.
ANTERIOR REGION
POSTERIOR REGIONS
13
PONTIC SELECTION

14. ANTERIOR PONTIC DESIGN –a
correctly placed anterior pontic should
have
1.All surfaces should be 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.
14
Pontic-residual ridge relationship: A research report.
Stein RS, J Prosthet Dent 1966; 16: 251

15. POSTERIOR PONTIC DESIGN –a correctly designed pontic
should have
1.All surfaces should be 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.
15
Pontic-residual ridge relationship: A research report. Stein RS, J ProsthetDent 1966; 16: 251

16. 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.
16

17. 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.
17

18. e)Modified Pin Facing
Facingismodifiedbyaddingporcelain
tolingualgingivalareaofapinfacing
f)Reversepinfacing–Porcelain
dentureteethcanbemodifiedto
beusedasthebridgefacing.
Porcelainisaddedtothegingival
endofthefacingandmultiple
precisionpinholesaredrilledinto
thelingualsurface
81
18

19. g. Harmony facing–
This facing is supplied with an
uncontouredporcelain 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.
i. Pontips:
Convex gingival surface having
pinpoint tissue contact and attached
to the backing occlusallywith
retentive pins.
81
19

20. SANITARY OR HYGIENIC PONTIC
Zero tissue contact
Occlusalgingival thickness should be atleast 3mm
Convex mesiodistally and faciolingually
Space beneath the pontic –2mm ( Rosenstiel)
 -3 mm ( Tylman)
Adequate space for cleaning
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
FISH BELLY
ARC-FIXED OR PEREL
81
20

21. A modified sanitary pontic
21
Perel M L : J Prosthet Dent 1972; 28: 587

22. SADDLE PONTIC 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.
22

23. 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.
23

24. The modified ridge lap ponticcombines the best features of the hygienic
and saddle pontic designs, combining esthetics with easy cleaning.
24
MODIFIED RIDGE LAP PONTIC
•Overlaps the residual ridge on
the facial (to achieve the
appearance of a tooth emerging
from the gingiva)
•Remains clear of the ridge on
the lingual side.
81

25. Tissue contact should resemble a letter Twhose vertical arm ends at the
crest of the ridge.
The ridge contact should be upto the midline of the edentulous ridge.
Most common pontic form used in areas of high visibility---
maxillary and mandibular anterior teeth and maxillary premolars and
first molars
25

26. 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.
26

27. The facial and lingual contours are dependent on the width of the
residual ridge;
a knife-edged residual ridge necessitates 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
Rosenstiel S F et al : Contemporary Fixed Prosthodontics, 4
th
edn

28. 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
28
OVATE PONTIC
Rosenstiel S F et al : Contemporary Fixed Prosthodontics, 4
th
edn

29. 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. 29
Rosenstiel S F et al : Contemporary Fixed Prosthodontics, 4
th
edn

30. 30
Rosenstiel S F et al : Contemporary Fixed Prosthodontics, 4
th
edn

31. 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,
31
BIOLOGIC CONSIDERATIONS

32. Pressurefreecontactbetweentheponticandtheunderlyingtissueis
indicatedtopreventedulcerationandinflammationofthesofttissues.
Whenaponticrestsonmucosa,someulcerationsmayappearasaresult
ofthenormalmovementofthemucosaincontactwiththepontic.
Positive ridge pressure (hyperpressure) may be caused by excessive
scraping of the ridge area on the definitive cast
32
RIDGE CONTACT

33. Ridge irritation microbial plaque between the gingival surface
of the ponticand the residual ridge
tissue inflammation and calculus formation.
33
ORAL HYGIENE CONSIDERATIONS
Normally, where tissue contact
occurs, the gingival surface of a
ponticis inaccessible to the bristles
of a tooth brush. Therefore, excellent
hygiene habitsmust be developed by
the patient.

34. 34
Devices such as proxy brushes, pipe
cleaners, Oral-B Super Floss, and
dental floss with a threaderare highly
recommended
Gingival embrasures around the pontic
should be wide enough to permit oral
hygiene aids.

35. Shouldprovidegoodestheticresults,biocompatibility,rigidity,and
strengthtowithstandocclusalforces;andlongevity.
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 ponticshave centered on two factors :
1.The effect of the materials and
2.The effects of surface adherence.
35
PONTIC MATERIAL

36. 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
ponticshould 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.
36

37. HENRY P J ET AL: TISSUE CHANGES BENEATH FIXED
PARTIAL DENTURES. J PROSTHET DENT 1966; 16: 937
placed14ponticsonhumangingivaltissue.
gingivalresponsetopolishedgold,Glazedporcelainorunglazed
porcelain
thereweregeneralhistologicchangesinthetissueunderallthe
materialstested.
notedthatglazedporcelainwasthemosthygienicmaterialusedandit
issuperiorintermsofestheticsandeaseofcleaning.
37

38. 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. 38
OCCLUSAL FORCES

39. Mechanical problems may be caused by
improper choice of materials
poor frame work design
poor tooth preparation
poor occlusion.
Therefore, evaluating the likely
forces on a ponticand designing
accordingly are important. For
example, a strong all metal pontic
may be needed in high stress
situations rather than a metal ceramic
ponticwhich would be more
susceptible to fracture.
39
MECHANICAL CONSIDERATIONS

40. A well fabricated metal ceramic
pontic is strong, easy to keep clean,
and looks natural.
40
METAL CERAMIC PONTICS
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

41. Resistance to abrasion is lower than enamel or porcelain,
no chemical bond existed between the resin and the metal framework,
41
RESIN-VENEERED PONTICS
•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

42. 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
42
FIBER-REINFORCED COMPOSITE RESIN
PONTICS

43. 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.
43
ESTHETIC CONSIDERATIONS

44. The modified ridge-lap ponticis
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
44

45. 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.
45
INCISOGINGIVAL LENGTH

46. In areas where tooth loss is
accompanied by excessive loss
of alveolar bone,the ponticis
shaped to simulate a normal
crown and root with emphasis
on the cementoenameljunction.
Therootcanbestainedto
simulateexposeddentin
46

47. 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. 47
GINGIVA-COLORED CERAMICS
Daniel E , H Spiekermann: A review of esthetic pontic design options. Quintessence Int
2002;33:736-746

48. 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.
48
ALL-CERAMIC GINGIVAL MASKS
Daniel E , H Spiekermann: A review of esthetic pontic design options. Quintessence Int
2002;33:736-746

49. CROSS REFERENCES
49

50. 50
J Prosthet Dent 2009;102:205-210
SIMULATED TISSUE USING UNIQUE PONTIC DESIGN
Kim.T.H.Yet al,

51. 51

52. 52
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).
Fiber-reinforced Composite Fixed Dental Prostheses
with Various Pontics
The Journal of Adhesive Dentistry2014Vol 16, No 2

53. 53
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 ponticsresulted in
higher load-bearing values

54. 54
PREFABRICATED WAX PONTICS
Advantages:
* Without collar
* Reduced occlusal depths
* Reinforced approximal surfaces
* 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

55. The ponticdesignis said to determine the success or failure of a
bridge.
Designs that allow easy plaque control are especially important to a
pontic’slong term success.
Minimizing tissue contact by maximizing the convexity of the
pontic’sgingival surface is essential.
Special consideration is also needed to create a design that
combines easy maintenance with natural appearance and adequate
mechanical strength.
55
CONCLUSION
The dentist should not attempt to duplicate nature exactly,
but should attempt to support it by supplying a prosthesis
based on sound biomechanical principles.

56. 1.RosenstielS F et al : Contemporary Fixed Prosthodontics,
4
th
ednMissouri, Mosby Inc, pg513
2.ShillingburgH T et al : Fundamentals of fixed
prosthodontics, ed4, Chicago , Quintessence
Publishing, pg485
3.TylmanSMaloneW. Tylman'sTheory and practice of fixed
prosthodontics. 8th ed.
4.The Glossary of Prosthodontic Terms. The Journal of
Prosthetic Dentistry. 2005;94(1):10-92.
5.CavozosE : Tissue response to fixed partial denture pontics.
J ProsthetDent 1968; 20: 143
6.Daniel Edelhoff, H Spiekermann: A review of esthetic
ponticdesign options. Quintessence Int2002;33:736-746
7.Henry P J et al: Tissue changes beneath fixed partial
dentures. J ProsthetDent 1966; 16: 937
56
REFERENCES

57. 7.PerelM L : A modified sanitary pontic. J ProsthetDent 1972; 28:
587
8.Stein RS: Pontic-residual ridge relationship: A research report. J
ProsthetDent 1966; 16: 251
9.KormanR. 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
PonticsThe Journal of Adhesive Dentistry2014Vol 16, No 2
11.Kim T, CascioneD, KnezevicA. Simulated tissue using a unique
ponticdesign: A clinical report. The Journal of Prosthetic Dentistry.
2009;102(4):205-210.
12.PurraAMushtaqM. Aesthetic replacement of an anterior tooth
using the natural tooth as a pontic; an innovative technique. The
Saudi Dental Journal. 2013;25(3):125-128. 57

58. 58
THANK YOU