Pontic Flashcards
What’s the ideal residual bridge characteristics?
- An ideally shaped ridge has a smooth, regular surface of attached gingiva, which facilitates maintenance of a plaque-free environment
- Its height and width should allow placement of a pontic that appears to emerge from the ridge and mimics the appearance of the neighboring teeth
- Facially, it must be free of frenum attachment and be of adequate facial height to sustain the appearance of interdental papillae
Loss of residual ridge contour complications?
unesthetic open gingival embrasures, food impaction and percolation of saliva during speech
What’s Class I defects of residual ridge ?
facio-lingual ( buccolingual ) loss of tissue width with normal ridge height
What’s Class II defects of residual ridge ?
loss of ridge height ( apical-coronal ) with normal ridge width
What’s Class III defects of residual ridge ?
a combination of loss in both dimensions
Buccolingual + apicocoronal
Class 2 and 3. Consideration before prosthodontics?
preprosthetic surgery to augment such residual ridges should be carefully considered
Few soft tissue surgical techniques can increase the height of a residual ridge with predictability
Which class Surgical augmentation of ridge width is uncommon.
Class 1
Resorption occurs primarily at which surface ?
buccal plate, resulting in a horizontal defect
How much bone loss after 6 months and 1 year ?
Bone loss averages 3 to 5 mm at 6 months after extraction
50% of the width of the alveolar ridge is lost at 12 months
Which methods aims in Gingival Architecture Preservation ?
1.The alveolar process can be preserved through ( immediate restorative and periodontal intervention )
- Conditioning the extraction site and providing a matrix for healing -preserving the preextraction gingival architecture
- An interim FDP can be fabricated indirectly, ready for immediate insertion
What’s the advantages of Gingival Architecture Preservation ?
- Aim of preserving the facial plate of bone
- The scalloped architecture of interproximal bone is essential for proper papilla form
- An interim FDP can be fabricated indirectly, ready for immediate insertion
- Immediately after preparation of the extraction site, a carefully shaped interim FDP is placed
When to prepare the abutment if want to do Gingival Architecture Preservation?
Before extraction
What’s sanitary / hygienic abutment disadvantages ?
- entrapment of food particles, which may lead to tongue habits
- Is the least toothlike design and is reserved for teeth seldom displayed during function
- is shaped like an archway between the retainers
What’s the modification of the prosthetic when we use hygienic Pontic ?
Increased connector size and a decrease in the stress concentrated in the pontic and connectors
What’s the saddle ridge lap ?
- 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
- Should be avoided because the concave gingival surface of the pontic is not accessible to cleaning with dental floss
In which situation not preferable to use conical Pontic and what instead ?
- May be unsuitable for broad residual ridges because the emergence profile associated with the small tissue contact point may create areas of food entrapment
The sanitary or hygienic pontic is the design of choice in these clinical situations - Esthetic regions
What’s the modified ridge lap and its characteristics ?
- Combines the best features of the hygienic and saddle pontic designs, combining esthetics with easy cleaning
- Overlaps the residual ridge on the facial side but remains clear of the ridge on the lingual side
What’s the characteristics that the modified ridge lap most have ?
- To enable optimal plaque control, the gingival surface must have no depression or hollow
- It should be as convex as possible from mesial to distal aspects
- Facial ridge adaptation is essential for a natural appearance.
What’s the super esthetic Pontic ?
Ovate then comes the modified ridge lap
What’s the design of ovate Pontic ?
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
What does ovate Pontic require to set ?
- Socket-preservation techniques should be performed at the time of extraction
- For a preexisting residual ridge, surgical augmentation of the soft tissue is typically required
- When an adequate volume of ridge tissue is established, a socket depression is sculpted into the ridge
In what argumention serve when we use ovate Pontic ?
With ridge augmentation, its emergence from the ridge appears identical to that of a natural tooth
What’s advantages of ovate ?
- Its recessed form is not susceptible to food impaction
- It is accessible to dental floss
- Super esthetic
Meticulous oral hygiene is necessary to prevent tissue inflammation resulting from the large area of tissue contact
What’s happen if support of the interim ovate pontic depression doesn’t done ?
The socket depression, with its pseudopapillae, will collapse when the interim restoration is removed before an impression is made
To compensate for this three-dimensional change in the socket that occurs during the impression making what should we do ?
it is necessary to scrape the cast in this area to ensure positive contact and support of the pseudopapillae with the definitive pontic
How does modified ovate Pontic site and its advantages ?
Apex positioned more facially on the residual ridge, rather than at the crest of the ridge
Cleansing of this pontic is also purported to be easiest of all pontic types
In which cases we use modified ovate Pontic ?
It’s alteration allows the use of the pontic in clinical scenarios in which
horizontal ridge width is not sufficient for a conventional ovate pontic
How does biological considerations of Pontic should be ?
- Pressure-free contact prevents ulceration and inflammation of the soft tissues
- Passive contact should occur exclusively on keratinized attached tissue
- Ovate pontics maintain positive tissue contact to support the pseudopapillae
- Healthy mucosa can be maintained if the contact to the mucosa is tight but noncompressive and the gingival portion of the pontic is regularly cleaned
- If any blanching of the soft tissues is observed, the pontic should be recontoured until tissue contact is entirely passive
Why biological considerations are important ?
- The biologic principles of pontic design pertain to the maintenance and preservation of the residual ridge, abutment and opposing teeth, and supporting tissues
2.Factors of specific influence are pontic-ridge contact, amenability to oral hygiene, and the direction of occlusal forces
How to maintain oral hygiene ?
- Gingival embrasures around the pontic should be wide enough to allow oral hygiene aids
To prevent food entrapment, they should not be opened excessively - To enable passage of floss over the entire tissue surface, tissue contact between the residual ridge and pontic must be passive
- If the pontic has a depression or concavity in its gingival surface, plaque accumulates and tissue irritation follows , This is usually reversible
- Accurate description of pontic design and correcting if necessary before cementation
Prevention is the best solution for controlling tissue irritation
Which material the easiest to keep clean ?
Highly glazed porcelain
For easier plaque removal and biocompatibility, the tissue surface of the pontic should be made in glazed porcelain
Why ceramic contraindicated in edentouloys patient ?
In areas where there is minimal distance between the residual ridge and the occlusal surface
What considerations if we use metal ?
If metal is placed in tissue contact, it should be highly polished
Why we should carefully use good material ?
To prevent tissue inflammation and polished surfaces easy to clean
Which prodesposing factors for mechanical failure ?
improper choice of materials, poor framework design, poor tooth preparation, or poor occlusion
These factors can lead to fracture of the prosthesis or displacement of the retainers
Why Long-span posterior FDPs are particularly susceptible to mechanical problems ?
Inevitably, significant flexing occurs as a result of high occlusal forces and because the displacement effects increase with the cube of the span length
When appearance is of utmost concern, what can we do ?
the ovate pontic, used in conjunction with alveolar preservation or soft tissue ridge augmentation,
can provide an appearance at the gingival interface that is virtually indistinguishable from that of a natural tooth
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