Fixed Prosthodontics

Burleson
CH. 26 - PONTICS AND EDENTULOUS RIDGES
The design of the prosthetic tooth will be dictated by esthetics, function, ease of cleaning, maintenance of ridge, and
patient comfort. Pontics may be metal-ceramic, cast metal, or resin processed to metal.
- due to porosity and difficulty in maintaining a high polish, resins should not be used on pontics near the tissue
- proper design is more important to cleansibility and good tissue health than is the choice of materials
- some of the supporting tissues are lost when the tooth is removed:
- therefore, the pontic lies over the tissue instead of growing from it and must be modified in its basic morphology
- the facial surface must be altered to curve gently from gingivofacial angle to the middle of the facial surface
Tissue Contact
- excessive tissue contact has been cited as a major factor in the failure of FPDs
- area of contact between pontic and ridge should be small and as convex as possible
- there must be no space between pontic and soft tissue on facial side = it will trap food
- also, if the tip of the pontic extends past the mucogingival junction, ulceration will result
- thus, the pontic should contact only keratinized gingiva
- the pontic should exert no pressure on the ridge or else inflammation is likely to result
- pontics not contacting the ridge may result in hypertrophied tissue if not meticulously cleaned / maintained
Post-Insertion Hygiene
- mesial, distal, lingual gingival embrasures should be wide open to allow the patient easy access for cleaning
- pontics designed for placement in the appearance zone must produce the illusion of being teeth without
compromising cleanability
- pontics in the non-appearance zone are there to restore function and prevent drifting of teeth, not esthetics
- pontic should lie on a straight line between abutments and can be made narrower to aid cleanability
Pontic Designs
1. Saddle (Ridge Lap) - looks most like a tooth; it forms a large concave contact with the ridge
- this design obliterates the facial, lingual, and proximal embrasures
- the saddle is impossible to clean, causes tissue inflammation, and should not be used!
2. Modified Ridge Lap - gives illusion of a tooth, but possesses all or nearly all convex surfaces for ease of cleaning
- may have a slight faciolingual concavity on the facial side of the ridge, as long as tissue contact is narrow
- ridge contact must extend no farther lingually than midline of the edentulous ridge
- this design is most commonly used pontic design in the appearance zone
3. Hygienic - pontics that have no contact with the edentulous ridge; called a sanitary pontic
- used in nonappearance zone, particular for replacing mandibular first molars
- it restores occlusal function and stabilizes adjacent and opposing teeth from drift and supraeruption
- occlusogingival thickness of the pontic should be at least 3.0mm
- it is made in an all-convex configuration, faciolingually and mesiodistally; called a fish belly
- an alternative form (concave archway mesiodistally) can also be used
- it reduces stress in the connectors, minimizes deflection in the denter of the pontic, and uses less gold
4. Conical - rounded and cleanable, but the tip is small in relation to the overall size of the pontic
- this form is well-suited for use on a thin mandibular ridge in the nonappearance zone
5. Ovate - round-end design in use where esthetics are a primary concern
- the tissue-contacting segment of the ovate pontic is bluntly rounded and set into a ridge concavity
- this pontic is easily flossed; concavity created by placing the pontic intto the socket after extraction
- this pontic works well with a broad, flat ridge - giving appearance that it is growing from the ridge
Edentulous Ridge Classification
1. Class I - resorption of faciolingual width but normal apicocoronal height
2. Class II - resorption of height with normal width
3. Class II - resorption of both height and width

(32.4%)
(2.9%)
(55.9%)