Pontics and Edentulous Ridges

Question 1

pontic \pŏn΄tĭk\ n:

Answer 1

An artificial tooth on a fixed partial denture that replaces a missing natural tooth, restores its function, and usually restores the space previously occupied by the clinical crown (GPT)

Question 2

Pontics may be

Answer 2

1. Metal-ceramic
2. Cast metal
3. Resin processed to metal

Because of the porous nature of resin and the difficulty in maintaining a highly polished surface on it, resins should not be used on pontics near the tissue.

Glazed or highly polished porcelain and gold with a mirror-like finish are preferred for tissue contact.

Proper design is more important to cleanability and good tissue health than is the choice of materials.

Question 2

Tissue Contact

Answer 2

• Excessive tissue contact has been cited as a major factor in the failure of fixed partial dentures contact between the pontic and the ridge should be small.
• The portion of the pontic touching the ridge should be as convex as possible
• If there is contact along the gingivofacial angle of the pontic, there must be no space between pontic and soft tissue on the facial side of the ridge
• If the tip of the pontic extends past the mucogingival junction, an ulcer will form there. The pontic should contact only attached keratinized gingiva

Question 2

Postinsertion Hygiene

Answer 2

The mesial, distal, and lingual gingival embrasures of the pontic should be open to allow the patient easy access for cleaning

The ipt should practice good hygiene around and under the pontic with dental floss or interproximal brushdependng on embrasure size, accessibility, and patient skill.

Question 2

Pontic Designs

Answer 2

• Saddle (ridge lap)
• Modified ridge lap
• Hygienic
• Conical
• Ovate
• Prefabricated pontic facings
• Metal-ceramic pontics

Question 3

The Edentulous Ridge Classification: Ridge deformities have been grouped into three categories by Seibert

Answer 3

• Class I: Loss of faciolingual ridge width with normal apico-coronal height
• Class II: Loss of ridge height with normal width
• Class III: Loss of both ridge width and height

If a “normal” classification (Class N) with minimal deformity is added, there are four classes of ridge contours.

Question 4

Pontic modification

Answer 4

In ridges with severe defects, where two or more pontics must be used to fill the space, it is not uncommon to eliminate gingival embrasure spaces between the pontics

Pink porcelain can be added to the gingival embrasure area of the pontic to simulate interdental papilla

Embrasure spaces filled with porcelain can be satisfactory when replacing mandibular molars and mandibular incisors where the gingival area is not subject to close scrutiny.

However, it is more difficult to achieve an esthetic result simply by modification of the embrasure spaces in a highprofile area such as the maxillary incisor region

Question 5

Surgical correction

Answer 5

Ridge augmentation can be accomplished by the addition of soft or hard tissue

Filling a ridge defect with bone is not essential unless the ridge is to be used for implants.

Excellent esthetic results in Class I defects can be obtained by connective tissue plastic surgery in the form of a subepithelial or submucosal connective tissue graft