61 - bridge resto0ration. elements. pontic profile

section

• define bridge

• elements of bridge

• classification of bridge

• what is pontic?

• factors to choosing pontic form

• requirements for pontics

• pontic designs

• preferred points at USC

• define bridge

fixed partial denture (FPD). They are used to replace missing teeth when there are sufficient number of adjacent teeth sitting next to the missing ones. This is done by joining an artificial tooth permanently to adjacent teeth for dental implants.

• elements of bridge

• retainer - part that seats on abutment teeth

• Pontic - suspended member of FPD that replaces missing tooth

• Abutment - tooth that provides support fort retainer

• Connector - provides connection between retainer and pontic

• classification of bridge

According to:

• Types of abutments:

  • natural

  • implant

• Connection to abutment:

  • fixed

  • removable

  • combined

• types of retainers:

  • full crown

  • partial crown

  • post-crown

• profile of pontic as per indicator hygiene:

  • hygienic

  • non-hygienic

  • semi-hygienic

• As per designation:

  • temporary

  • permanent

• According to material:

  • metals - gold, non-precious and precious alloys

  • composite-fiber reinforced

  • ceramics

  • combined

• According to way of manufacturing:

  • made by casting

  • made by sintering

  • made by polymerization

  • made by CAD/CAM

• According to mode of fixation:

  • Simple:

    • fixed-fixed

    • fixed supported

    • fixed-free

    • spring-cantilever

  • Compound

• According to site:

  • Anterior:

    • Uni-lateral

    • Bi-lateral

  • Posterior

  • Complex

• what is pontic?

Pontic is the portion of the fixed partial denture that replaces the missing tooth or teeth. They are usually connected to the retaining crowns which fit into abutment teeth.

• factors to choosing pontic form

There are three main factors in choosing a pontic form:

• edentulous ridge:

  • Shape

  • Width

  • current condition

• aesthetic considerations

• Patient homecare and hygiene

• requirements for pontics

• constructed in a way to prevent food entrapment therefore it should be attached closely to gingiva.

• should be smooth as possible, especially on the gingival surface to reduce the amount of plaque.

saddle (ridge lap)

• has full contour buccal and lingual to edentulous ridge

• Advantage: the full contour gives a nice facial and lingual aesthetics

• Disadvantage: difficult for cleaning especially under the pontic therefore homecare is difficult

modified ridge lap

• Full contour on the buccal side but on lingual side part of the saddle is missing

• Advantage: provides adequate facial aesthetic and increases hygienic access to gingival of pontic for cleaning. -

• Disadvantage: decreased lingual contour and increased possibility of food entrapment.

hygienic

• Totally open access under the Pontic for hygiene.

• Advantage:3mm space between the gingiva and the pontic giving easier access for hygiene and decreasing the possibility of food entrapment. Very simple for cleaning only for distal teeth.

• Disadvantage: no aesthetics due to lack of facial and lingual contour.

ovate

• Egg shaped end that protrudes into a concavity in the edentulous tissue.

• Option for frontal teeth.

• Advantage: super aesthetics -

• Disadvantage: requires a wide ridge to perform possibly indicating ridge augmentation surgery. Can use only after extraction or the patient needs additional surgery!!

bullet

• Comes to a pointy area like the more pointed end of an egg which challenges the tissue.

• Advantage: increased hygienic access to buccal and lingual surfaces. Can be used against a variety of ridges.

• Disadvantage: decreased aesthetics due to lack of full contour on the facial and lingual area.

preferred points 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 the combination of aesthetics and hygiene.