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26 Pontics & Ridge

This document summarizes key considerations for pontic and edentulous ridge design in fixed prosthodontics. The pontic design must balance esthetics, function, cleanability and tissue health. Proper design is more important than material choice. Pontics no longer grow from the ridge and must be modified to curve gently from the gingivofacial angle. Excessive tissue contact can cause failure, so contact should be small and convex. Several pontic designs are described, with the modified ridge lap and hygienic designs generally recommended for appearance and non-appearance zones respectively.

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120 views1 page

26 Pontics & Ridge

This document summarizes key considerations for pontic and edentulous ridge design in fixed prosthodontics. The pontic design must balance esthetics, function, cleanability and tissue health. Proper design is more important than material choice. Pontics no longer grow from the ridge and must be modified to curve gently from the gingivofacial angle. Excessive tissue contact can cause failure, so contact should be small and convex. Several pontic designs are described, with the modified ridge lap and hygienic designs generally recommended for appearance and non-appearance zones respectively.

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drgayen6042
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We take content rights seriously. If you suspect this is your content, claim it here.
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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%)

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