PONTICS

BY
Shams Waaz Amgad Aly
• Definition

• Function

• Pre-treatment assessment

• Requirements.

• Pontic design Principles

• Classifications
 What are the
Bridge
Components???
 4 4
3 3
2

1 1
Definition
 Definition

 It acts as the actual substitute for the

lost tooth and is suspended between the
retainers replacing the lost natural tooth
functionally and esthetically.
Pontic (Dummy)
 The pontic is attached to the
retainer by a rigid connector such
as ( solder joint) or non rigid
connector in special cases such as
(key and keyway)
Pontic Function
 Improve esthetics
 Restore function mastication &
speech.
 Stabilize occlusion & maintain the
adjacent teeth relationship.
 Pt‘s psychological needs.
Pre-treatment
Assessment
1-Dimension of E A

2-Form & shape of the gingival

surface (Ridge Contour)

 1-Dimension of E A
Pontic Space :

MD Dimensions
& OG Dimensions

 Why do change that

pontic space ????
 If the space reduced:
orthodontically reposition abutments
modify the abutment retainer type,
or design a small pontic (posterior area)

 It is better to make a diagnostic wax up

 It is better to design retainers with

increased proximal contours rather than
making undersized pontic.
 2-Form & shape of the gingival
surface
Siebert 's ridge contour classification

where there is NO defect, normally looking ridge contour

Class I defect: where there is loss of BL tissue width with
normal ridge height
Class II defect: where there is loss of ridge height with
normal width………surgical ridge augmentation.
Class III defect: where there is loss of tissues on both
dimensions ……………surgical ridge augmentation
Requirements
 Requirements

Mechanical Biological

Esthetics
A-Mechanical
 A-Mechanical
 Adjust existing occlusion

 Maintain neighboring abutment teeth position

avoiding tilting or drifting

 Allow enough space for strong connector

 Prevent torque or fracture

This is affected by:
1-Edentulous Area Dimension

2-Curvature of the bridge(inter abutment

axis)

3-Rigidity and strength of pontic material

1-Edentulous Area Dimension

Mesio-distally dimension
Occluso-gingivally dimension
 1-Edentulous Area Dimension
Limitations for edentulous area for construction
of fixed prosthesis:
1-maximum of two missing posterior teeth
2-maximum of four missing anterior teeth
3-maximum of missing canine and one
adjacent tooth

WHY ?????
 There is one unit of
deflection (X) for a given
span length (p)

The deflection will be

8 times as great (8X) if
the span length is
doubled (2p).
Consequences of flexing(bending)

1-Fracture Of Connectors
2-Fracture Of Porcelain Veneers
3- Retainer Looseness
4- Soft Tissue Response
The more the EA length the more the flexing
(bending)
How to decrease bending????
•Use alloy of high yield strength
•Increase occluso gingival dimension of Pontic
•Add abutment
•Full coverage
•Retentive means
Double abutments
 Occluso-gingivally dimension:

According to the amount of over eruption :

 Enamel only ► Enameloplasty + fluoride
application.

 Enamel + Dentin ► Crown or Onlay .

 Enamel + Dentin + Pulp ►endo ttt + Crown

 Sever over eruption ►extraction.

Aim: to restore normal level of occlusal plane.
Tooth extraction is the only choice if large
portion of tooth blocked the pontic space
 2-Arch Form
(Inter abutment axis)
Arch form affects the amount of
stresses occurring on F.P.D

Pointed ( V- shaped) arch

anteriorly pontics lie outside the
inter-abutment axis line act as
lever arm
Inter abutment axis: abutments on straight line
resist movement in one direction i.e. mesiodistal
but those on curved path resist both mesiodistal
and buccolingual movements e.g. canine case.

SO, pontics must be close to the interabutment

axis to reduce the torque on them and alter
stresses to be favorable
 To overcome this problem
•The resistance arm(R)
should be equal to or greater
to lever arm (P)
3-Rigidity and strength of pontic material

 Rigidity and strength ► ► to

withstand occlusal forces and longevity.
B-Biological
 B-Biological
Material should be biocompatible :
 Cleansable and hygienic (Not allow food
accumulation)

 No ridge irritation or pressure ( Only

passive contact)

 Position and thickness should restore

proper mastication and speech .
C- Esthetics
 C- Esthetics

 Natural appearance by proper pontic shape,

size, form and contour( as emergence
profile)

 Restore Residual ridge loss by pink

porcelain

 Support lip and cheek contour

 Illusions can be used to modify esthetics

 Illusion ( line angles)
 Pontic Design
Principles
(Factors affecting Pontic design)
 Principles

Mechanical Biological

Esthetics
I-Biological Principles
 I-Biological Principles

 Depends on:
1- Ridge Contact
2- Oral Hygiene
3- Pontic Material
4-Occlusal Forces
 1-Ridge Contact

 Pressure-free contact
between the pontic and
the underlying tissue
WHY????

To prevent ulceration and inflammation of the

gingiva
 Anterior region:

due to esthetic is
important ► should
contact the gingiva on
labial surface to give
more natural appearance.
 Posterior region:
Due to attention paid to occlusion, function
and hygiene ► should non-contact the
gingiva
 2- Oral Hygiene
Shape of gingival surface , its relation to the
ridge and material affect plaque control.
 3-Pontic Material

It must be highly biocompatible

Well-polished gold is
smoother , less prone
to corrosion and less
retentive to plaque
than an unpolished or
porous casting. .
Glazed porcelain
surface under
microscope shows
many voids , rougher
than polished gold.
But it is easier to
clean than other
materials.
 4-Occlusal Forces

Reducing the BL width of the pontic by as

much as 30% has been suggested as a way to
lessen occlusal forces and loading over
abutment teeth BUT little scientific basis
WHY ????
That forces are lessened only when chewing
food of uniform consistency.

Para function forces are not reduced by

narrowing the occlusal table.
SO pontics with normal
occlusal widths ( at least
on the occlusal third )
are recommended.
 EXCEPT if the residual alveolar
ridge has collapsed BL.
Reducing the pontic width is
desired ……WHY???

 Facilitating plaque control measures

The direction of forces

• Posterior region; the direction of forces

is with the long axis of the tooth.
• Anterior region;
Upper --- the direction of forces is
palatally toward labially.
Lower ----- the direction of forces is
labially toward lingually and with the long
axis of the tooth.
II- Mechanical Principles
 II- Mechanical Principles

 Mechanical problems due to:

 Improper choice of materials

Poor framework design
 Proper Framework Design
• Porcelain 1.2mm thick

(excessive thickness ------- inadequate

support ---- liable to fracture).

• Metal ----- smooth and free of pits.

(roughness ---- creating voids ---- affect the

bond strength )
• Roundation of Sharp line angles .

• MC junction must be at least 1.5 mm

away from the centric occluding

contact.
Avoid Any Sharp , Acute Angles
Occlusal Contacts should away from P/M
Junction to avoid porcelain fracture
Metal ceramic junction should NOT be in
contact with residual ridge
III-Esthetic Principles
 III-Esthetic Principles
When properly designed , a modified ridge-lap
pontic provides the required convexity on the
tissue side.

Smoothness and open embrasures at the ligual

side for cleaning.

Contour of the labial surface should appear

natural (diagnostic waxing )
Pontic must be well adapted to the residual
ridge, especially in the cervical area.
Balance :It depend on the location of the
midline
Golden proportion
Facial view, the width of each anterior tooth is
60% of the width of the adjacent tooth
(mathematical ratio being 1.6:1:0.6).
The position of anterior contact point
should progress from incisal to cervical
from centrals to canines.
Size of Interproximal contact area
(Connector space)
The incisal embrasures should display a
natural, progressive increase in size or depth
from the central to the canine.
Classifications
 Classifications

Method of
Material
Fabrication

Mucosal Contact
(Ridge Relation)
 I-Material
• Metal
• Non-Metal
• Combination
o Resin veneered pontics
o Fiber reinforced composite
resin pontics
 II-Mucosal Contact
(Ridge Relation)

Mucosal Contact Non-Mucosal Contact

1-Ridge lap
1-Sanitary (Hygienic)
2-Modified ridge lap
3-Conical 2-Modified Sanitary
4-Ovate
Mucosal Contact
1-Ridge lap ( Saddle)

Not recommended
….WHY???
 1-Ridge lap ( Saddle)
 Shape of gingival surface:
- Concave-Concave bucco-lingually
-Touching E A passively

 Advantage:
Excellent esthetics

 Disadvantage :
Inaccessible for cleaning ► plaque
accumulation ► soft tissue inflammation
+ bad odor ► bone resoption

 Clinical Application:
- Not used ( not hygienic)
2- Modified
Ridge lap

the most common pontic

design used in visible areas
 2- Modified Ridge lap
 Shape of gingival surface:
- Concave-Convex bucco-lingually
-Touching E A passively
- T-shaped of the cross section of tissue
contact
 Advantage:
Excellent esthetics
Accessible for cleaning

 Clinical Application:
Esthatic area
( anterior , premolar & some mx molars )
3-Conical

for mandibular posterior, knife edge ridges

 3- Conical
(Egg, Heart shaped, Bullet)
 Shape of gingival surface:
- Convex BL & MD
-Touching E A in point

 Advantage:
Accessible for cleaning

 Disadvantage : Bad esthatic

 Clinical Application:
Knife edge ridge
Not in broad ridge to avoid shelf
formation
4-Ovate
 4- Ovate
 Shape of gingival surface:
- Convex BL & MD
-Resting in a depression in E A
( after recent extraction)
or (surgical intervention )

 Advantage:
The most esthatic
( emerge from socket)

 Clinical Application:
Immediate bridge
Non-Mucosal Contact
 1- Sanitary ( Hyigenic)
 Shape of gingival surface:
- Convex BL & MD
-Half ball
- away from EA =2mm

 Advantage:
Proper Cleaning

 Disadvantage:
Bad esthatic

 Clinical Application:
Posterior area
 2- Modified Sanitary
 Shape of gingival surface:
- Convex BL & Concave MD
-Arch shape
- away from EA =2mm

 Advantage:
Proper Cleaning

 Disadvantage:
Bad esthatic

 Clinical Application:
Posterior area in limited OG height
 III-Method of Fabrication

Ready Made Custom Made

 Prefabricated Pontic
 Pin facing

 Reverse pin facing

 Steel flat back facing

 True pontic

 Sanitary pontic

 Poreclain bitting edge

Pin facing
 Reverse Pin facing
 Steel flat back facing
THANK YOU