Fixed Partial Denture Pontics

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Fixed Partial Denture Pontics

• February 7, 2005
• DDS Class of 2007
• Brent Fung

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A Quote for the Day

• "In looking for people to hire, look for three
  qualities integrity, intelligence and energy.
  And if they don't have the first, the other two
  will kill you."
• Warren Buffet, American financier

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FPD Pontics

• What is a Pontic?
• A pontic is the portion of a fixed partial
  denture that replaces missing tooth or teeth.
• They are usually connected to retaining crowns
  which fit onto abutment teeth.

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Factors in Choosing a Pontic Form

• There are three main factors to consider when
  deciding on which pontic shape and restorative
  material to use
• 1) Edentulous Ridge
• Shape
• Width
• Current Condition
• 2) Esthetic Considerations
• 3) Patient Homecare Hygiene

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Requirements of Pontics

• Pontics should challenge the gingiva where
  indicated by pontic design to prevent food
  entrapment under the pontic.
• Pontics should be as smooth as possible
  especially on the gingival surface to reduce the
  amount of plaque.

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Pontic Designs

• Saddle (aka Ridge Lap)
• Modified Ridge Lap
• Hygienic
• Ovate
• Bullet

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Pontic Designs

• Saddle (or Ridge Lap)
• Full contour buccal lingual to edentulous
  ridge.
• Advantage
• Full contour gives nice facial and lingual
  esthetics
• Disadvantage
• Difficult Patient Homecare under Pontic.

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Pontic Designs

• Modified Ridge Lap
• Full contour on the buccal side, but tissue
  contact only to one millimeter lingual to the
  crest of the edentulous area.
• Advantages
• Provides adequate facial esthetics and increases
  hygienic access to gingival of pontic.
• Disadvantages
• Decreased lingual contour increased
  possibility of food entrapment.

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Pontic Designs

• Hygienic
• Totally open access under the pontic for hygiene.
• Advantages
• 3 mm space gives simple access for hygiene
  decreases the possibility of food entrapment.
• Disadvantages
• Esthetics due to lack of facial lingual
  contour.

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Pontic Designs

• Ovate
• Egg-shaped end that protrudes into a concavity in
  the edentulous tissue.
• Advantages
• Super esthetics due to mimiced papillary form
  which is usually lost post-extraction due to bone
  deterioration.
• Disadvantages
• Requires a wide ridge to perform possibly
  indicating ridge augmentation surgery.

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Pontic Designs

• Bullet
• Comes to a pointy area like the more pointed end
  of an egg which challenges the tissue.
• Advantages
• Increased hygienic access to buccal lingual
  surfaces.
• Can be used against a variety of ridges.
• Disadvantages
• Decreased esthetics due to lack of full contour
  on the facial lingual.

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Preferred Pontics at USC

• Anterior Pontics
• Whenever possible, the use of an OVATE pontic is
  suggested due to esthetics, if the ridge can
  satisfy the requirements for such a pontic.
  Otherwise, a Modified Ridge Lap will work nicely
  here.

• Posterior Pontics
• MODIFIED RIDGE LAP pontics are the most widely
  used pontics in the posterior region due to
  combination of esthetics and hygiene.

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Patient Homecare Adjuncts

• There are three items that are used to help clean
  underneath a pontic.
• Floss Floss Threaders
• Superfloss
• Proxybrushes

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Patient Homecare Adjuncts

• Superfloss
• Yarn-like floss that has a plastic lead like a
  floss threader.
• Proxybrushes
• Pipe-cleaner-like brushes that have different
  shapes to fit different areas. These are the
  least likely to fit of the adjuncts.

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Choosing a Pontic Form

• Which pontic would you choose in each of these
  cases?

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Edentulous Ridges, Pontics, and Final Results