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Impression technique for ovate pontics

Article  in  The Journal of prosthetic dentistry · January 2011

DOI: 10.1016/S0022-3913(10)60194-1 · Source: PubMed

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Diego Klee de Vasconcellos Cláudia Ângela Maziero Volpato

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 Impression technique for ovate pontics

Diego Klee de Vasconcellos, DDS, MSc, PhD,a Cláudia Ângela

Maziero Volpato, DDS, MSc, PhD,b Izo Milton Zani, DDS, MSc,
PhD,c and Marco Antonio Bottino, DDS, PhDd
Federal University of Santa Catarina, Florianópolis, Santa
Catarina, Brazil; São José dos Campos School of Dentistry,
São Paulo State University (UNESP), São José dos Campos,
São Paulo, Brazil
A convex surface has been ad- inflammation.6 The sculpted tissue nique allows the fabrication of a reli-
vocated for the pontics of posterior beneath the pontics must be accu- able cast so that the dental laboratory
and anterior fixed partial dentures rately transferred to a cast to provide technician can appropriately develop
(FPDs).1 A modified ridge lap pontic the dental laboratory technician with the definitive FPD. Mucosa will remain
establishes gentle contact on the la- the necessary information to fabri- healthy irrespective of the definitive
bial surface of the alveolar mucosa, cate a definitive restoration with an pontic material used (metal or por-
with no contact on the palatal sur- appropriate emergence profile.4,5,6 celain), if the patient maintains good
face.2,3 This design facilitates good Use of elastomeric materials to oral hygiene and removes plaque ef-
oral hygiene and cleaning of the pon- make the impression of the alveo- ficiently from the smooth convex pon-
tic. However, esthetics are compro- lar mucosa, regardless of the tech- tic area.7 However, the technique has
mised, since a complete emergence nique used, may alter the shape of limitations. The framework is fabri-
profile cannot be obtained because of the sculpted tissue due to the den- cated without information regarding
the convex shape of the alveolar ridge. sity of the impression material. This the definitive gingival contours and,
In addition, this design commonly may provide inaccurate information therefore, may not provide adequate
creates palatal food traps and causes to the dental laboratory technician support for the porcelain in particular
phonetic difficulties, as air and saliva with respect to the tissue contours. areas.
are pushed through from the lingual Additionally, the shape of the alveo-
surface.4 lar mucosa may be distorted during PROCEDURE
The ovate pontic design, as de- the impression making due to tissue
scribed in the literature,1,4,5 allows- collapse caused by the removal of the 1. Create a provisional restoration
for an excellent esthetic outcome. To provisional FPD. that simulates the design of the de-
sculpt the tissue beneath the pontics, This article describes a safe and finitive restoration.
provisional restorations with ovate effective impression technique for 2. Use the provisional restora-
pontic designs should be provided use when fabricating ovate pontics. tion to sculpt the soft tissue, as rec-
for tissue guidance and stabilization.1 In this method, the provisional resto- ommended by Jacques et al1 (Fig.
The controlled pressure applied to the ration is used for easy and accurate 1, A). After tissue sculpting, make a
soft tissues of the residual ridge by transfer of the tissue features to the complete arch impression by using a
the smooth convex pontic, along with cast, avoiding tissue collapse caused custom tray fabricated with light-po-
good plaque control, results in a thin- by the removal of the provisional FPD lymerizing material (Triad; Dentsply
ning of the epithelium and shortening and tissue compression produced by Intl, York, Pa) and polyether impres-
of rete pegs, without causing tissue the impression material. This tech- sion material (Impregum F; 3M ESPE,

a
Adjunct Professor, Department of Dentistry, Federal University of Santa Catarina.
b
Adjunct Professor, Department of Dentistry, Federal University of Santa Catarina.
c
Associate Professor, Department of Dentistry, Federal University of Santa Catarina.
d
Full Professor, Department of Dental Materials and Prosthodontics, São José dos Campos School of Dentistry, São Paulo State
University (UNESP).
(J Prosthet Dent 2010;105: 59-61)
Vasconcellos et al
60 Volume 105 Issue 1

A B

C
1 A, Occlusal view of sculpted alveolar mucosa. B, Provisional FPD inside impres-
sion. C, Framework on silicone cast. Pontic site reproduced with acrylic resin.

A B
2 A, Frontal view of cast with removable silicone artificial gingiva. B, Definitive restoration placed intraorally.

St. Paul, Minn). Use nonimpregnated
retraction cord for gingival retraction
(Ultrapack Cord no. 00; Ultradent
Products, Inc, South Jordan, Utah).
Cast the impression with type IV den-
tal stone (Durone; Dentsply Intl, York,
Pa) to produce a definitive cast that
will allow the dental laboratory tech-
nician to fabricate the FPD framework
(InCeram Alumina; VITA Zahnfabrik,
The Journal of Prosthetic Dentistry
Bad Säckingen, Germany).
3. Evaluate the framework intra-
orally. Use the customized transfer
impression technique as described in
the following steps.
4. With the provisional FPD in po-
sition (without provisional cement),
make a transfer impression of the
FPD, using a heavy-body vinyl poly-
siloxane material (Zetaplus System;
Zhermack SpA, Rovigo, Italy). Remove
the impression from the mouth, ensur-
ing that the provisional restoration re-
mains in the impression (Fig. 1, B).
5. Isolate the impression and the
provisional restoration with petro-
leum jelly. Inject a medium-body vi-
nyl polysiloxane impression material
(Aquasil; Dentsply Intl, York, Pa) into
the impression to obtain a silicone
Vasconcellos et al
January 2011
cast (silicone allows the cast to be
made as quickly as possible, while the
patient is waiting). After the impres-
sion material polymerizes, remove the
silicone cast from the impression. If
necessary, trim the silicone cast with
a surgical scalpel (No. 11; Hu-Friedy
Co, Inc, Chicago, Ill).
6. Adapt the FPD framework on
the silicone cast. With the bead-brush
technique, place acrylic resin (GC
Pattern Resin; GC America, Inc, Alsip,
Ill) beneath the pontic, until contact
with the pontic site of the silicone
cast is obtained. Note that the gingi-
val surface of the provisional pontic
is reproduced by the acrylic resin and
will remain joined to the framework
pontic (Fig. 1, C).
7. Place the customized FPD
framework intraorally over the abut-
ment teeth and make a definitive
transfer impression using heavy- and
light-body vinyl polysiloxane (Aquasil;
Dentsply Intl) simultaneously.
8. Pour the impression with soft
tissue cast material (Coltex Extrafine;
Coltene Whaledent, Inc, Cuyahoga
Falls, Ohio) and type IV dental stone
(Durone; Dentsply Intl) to create a
cast with artificial gingiva represented
in silicone (Fig. 2, A). Note that the
soft tissue cast material used in the
pontic site to avoid fracture of thin
plaster margins in this area allows the
dental technician to fabricate a pon-
tic with contours identical to those of
the provisional pontic (Fig. 2, B).
REFERENCES
1. Jacques LB, Coelho AB, Hollweg H,
Conti PC. Tissue sculpturing: an alternative
method for improving esthetics of anterior
fixed prosthodontics. J Prosthet Dent
1999;81:630-3.
2. Becker CM, Kaldahl WB. Current theo-
ries of crown contour, margin place-
ment and pontic design. J Prosthet Dent
1981;45:268-77.
3. Howard WW, Ueno H, Pruitt CO. Stan-
dards of pontic design. J Prosthet Dent
1982;47:493-5.
4. Dylina TJ. Contour determination for ovate
pontics. J Prosthet Dent 1999;82:136-42.
61
5. Edelhoff D, Spiekermann H, Yildirim M. A
review of esthetic pontic design options.
Quintessence Int 2002;33:736-46.
6. Tripodakis A, Constantinides A. Tis-
sue response under from convex pon-
tics. Int J Periodontics Restorative Dent
1990;10:408-14.
7. Zitzmann NU, Marinello CP, Berglundh
T. The ovate pontic design: a histologic
observation in humans. J Prosthet Dent
2002;88:375-80.
Corresponding author:
Dr Diego Klee de Vasconcellos
Department of Dentistry
Federal University of Santa Catarina
Rua: Dom Joaquim, 866, ap 801
Florianópolis, SC
CEP: 88015-310
BRAZIL
Fax: +55 48 3721 9520
E-mail: diegokv@terra.com.br
Acknowledgments
The authors thank dental technician Márcio
Breda, and Wilcos (Petrópolis, Brazil) and
Conexão Sistemas de Prótese (São Paulo,
Brazil) for their support of this study. The ce-
ramic used in this study was provided by VITA
Zahnfabrik (Bad Säckingen, Germany).
Copyright © 2010 by the Editorial Council for
The Journal of Prosthetic Dentistry.

Noteworthy Abstracts of the Current Literature

Survival rates of porcelain molar crowns—an update

Kassem AS, Atta O, El-Mowafy O.

Int J Prosthodont 2010;23:60-2.

The aim of this study was to identify recent studies that dealt with the clinical performance of porcelain molar crowns
and to explore the possibility of grouping the findings from similar studies together to draw overall conclusions. A
MEDLINE literature search was conducted in early 2009 covering the preceding 12 years. Seventeen studies were iden-
tified. However, only seven met the specific inclusion criteria and were analyzed. Among seven studies, five European
countries were covered. Five studies reported on Procera AllCeram molar crowns while one reported on In-Ceram
Alumina and Spinell crowns and another on CEREC crowns. For comparison, one additional study that reported on
premolar crowns was included. In the five Procera AllCeram studies, 235 molar crowns were evaluated for 5 or more
years, of which 24 failed. When the results of the five studies on the performance of Procera AllCeram molar crowns
were considered collectively, an overall failure rate of 10.2% was found at 5 or more years.

Reprinted with permission of Quintessence Publishing.

Vasconcellos et al
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