Pontics

Definition
The suspended member of a bridge which replaces the crown of the lost
tooth.

Classification:

A. shape (relation of the pontic to the residual ridge):

1. Saddle (ridge lap).
2. Modified ridge lap.
3. Hygienic (sanitary).
4. Conical.
5. Ovate.

B. Material (pontic made from what?):

1. All metal.
2. Resin.
3. Ceramic.
4. combinations
i. Metal with resin.
ii. Metal with porcelain.

C. Prefabricated:
1. Slot back.
2. Pin facing.
3. True pontic.
4. Reverse pin facing.
General notes:

- Pontics maybe metal to ceramic, cast metal or less commonly resin to

metal.
- Pontic must be shortened apically (gingival side of the pontic).

 Tissue contact:
- Excessive tissue contact considered as a major factor in the failure of
the bridge.
- Area of contact between the pontic and the ridge should be small.
- Portion of the pontic touching the ridge should be as convex as
possible.
- There must be no space between pontic and soft tissue on the facial
side of the ridge.
- If the tip of the pontic extends to the mucogingival junction → cause
ulceration.
- The pontic should contact only attached keratinized gingival.
- Close adaptation of the pontic with tissue is not indicated why?
- Because this leads to pressure on the ridge causing inflammations.
 Post insertion hygiene:

- The mesial, distal and lingual gingival embrasures of the pontic

should be wide open to allow easy cleaning.
- Contact between pontic and tissue must allow the passage of floss
from one retainer to another.
- Appearance zone → areas of high visibility.
- Non appearance zone → areas completely or partially non visible.
Ex: mandibular posterior segment where the pontic aid for restore function
and prevent the drifting of teeth.

- The pontic should be as straight line as possible between the retainers

to prevent any torquing of the retainer and abutment.
- The pontic should be narrow at the lingual surface.
Pontic design:

1. Saddle ( ridge lap)

- This pontic replacing all the contour of the missing tooth.
- It forms a large concave contact with the ridge (close adaptation with
the ridge).
- This design recognized as uncleansable because the floss can not
traverse the tissue–facing area of pontic.
- The saddle cause tissue inflammation and should not be used.
2. Modified ridge lap:
- Possesses nearly all convex surfaces for ease of cleaning.
- The lingual surface have slight deflective contour to prevent food
impaction.
- The contour of the tissue–contacting area of pontic should be convex.
- Most commonly used pontic design in the appearance zone for both
maxillary and mandibular bridges.
3. Hygienic:
- This pontic have no contact with edentulous ridge.
- Used in non appearance zone (mandibular molar pontics.
- It restores occlusal function and stabilizes adjacent and opposing
teeth.
- If there is no requirement for esthetic it can be made entirely of metal.
- The occluso–gingival thickness of pontic should be no less than 3mm.
- It’s frequently made in an all–convex configuration faciolingually and
mesodistally.
- The undersurface of the pontic → round without angles allows for
easy flossing.
- This pontic also maybe made in the form of concave arch way
mesiodistally.
4. Conical:
- Rounded and cleanable.
- Its tip is small in relation to the overall size of the pontic.
- Indicated for thin mandibular ridge in non appearance zone.
- If used with broad, flat ridge resulting in large triangular embrasure
space around the tissue contact which have tendency to collect debris.
5. Ovate:
- Round end design of pontic.
- Used when the esthetic is a primary concern.
- The tissue–contact segment of ovate pontic is bluntly rounded and is
set into a concavity in the ridge.
- The concavity of the ridge can be created by:
→placement of provisional bridge with the pontic extending ¼ of the
way into the socket immediately after extraction.
→ created surgically.
6. Prefabricated pontic facing.
7. Metal ceramic pontic:
- Indicated when the esthetic is required.
-

- Occlusal surface of the pontic:

- Occlusal table → reduced why?

- to reducing forces.
- Maxillary cusps should be designed to be:
→ Esthetic.
→ To prevent cheek biting.
- mandibular lingual cusps → should not be reduced why?
- Because they protect the tongue.

N.B:

The occlusal table of the pontic is altered only to create a favorable

relationship between the pontic and opposing occlusion when space has been
lost due to drifting or extrusion.
Inter proximal surface of pontic:
- mandibular posterior area → wide embrasure for easy cleaning.

Gingival surface:
- Avoid rough surface → to avoid plaque accumulation and irritation.
- For mandibular posterior → sanitary (3mm space).
- For maxillary posterior → modified ridge lap.
- Anterior:
o Esthetic is important.
o In case of minimal bone loss → M.R.L.
o Excessive bone loss → elimination of embrasure.

Buccal and lingual surface:

- In the maxillary pontics embrasures on the lingual are wider than that
on the facial.
- For mandibular segment → the same.

Residual ridge:
- It’s the boundaries of edentulous space.
- When a tooth is lost, the residual ridge is formed of gingival and
alveolar mucosa.
- Pontic should be away from movable mucosa why?
- If there are irregularities in supporting tissue → corrected surgically.
- If the vertical height is insufficient → residual ridge is lowered.
- If opposing teeth are supererupted into the edentulous space → R.C.T
and shortening of the opposing crown.
Classification of the residual ridge:
- Class N (normal):
Minimal change in the ridge.
- Class I:
Loss of faciolingual width of ridge with normal apico–coronal
height.
- Class II:
Loss of ridge height with normal width.
- Class III:
Loss of both ridge width and height.
N.B:
In case of sever class II residual ridge with multi tooth Pontics Bridge,
the unwonted appearance of black triangle (gingival embrasure) will be
created.
We can manage this problem by adding pink porcelain to the gingival
embrasure area of pontic to simulate inter dental papilla.
Requirements of pontic:

1. Restore function.
2. Provide esthetic and comfort.
3. Biologically acceptable.
4. Permit effective oral hygiene.
5. Preserve underlying residual ridge.

Pontic selection:
Depend on:
1. Retainers.
2. Esthetic.
3. Occluso–gingival height and mesiodistal width of edentulous area.
4. Ridge resorption.

- if retainers are P.F.M → pontic selected P.F.M.

- Partial veneer retainers → prefabricated facing + using the same metal
as a retainer.
- Complete metal retainers → select (all metal) pontic.
- Maxillary anterior segment → esthetic is critical → modified ridge
lap.

N.B

When multiple teeth missing the interproximal embrasures are minimized on

the facial surface why?

- To prevent undesirable inter proximal empty spaces and to avoid

whistling sounds.
- Contour of gingival portion → usually concave faciolingually and
convex mesiodistally.
- Mandibular posterior pontics → sanitary.
- Maxillary posterior pontics → if esthetic
required → modified ridge lap.
- Occlusogingival height and mesiodistal width of edentulous space:
o If long span and esthetic not required → all metal.
o If long span and esthetic is required → P.F.M.
- Ridge resorption:
o Tissue clearance between pontic and edentulous ridge should be
at least 3mm.
o If there is sever ridge resorption → recontouring and ridge
augmentation may be indicated.