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Pontics seminar
The document discusses dental considerations for pontic designs and orthodontic treatments, focusing on the aesthetic and functional aspects of replacing anterior teeth. It outlines the importance of ridge preservation techniques and classifications of pontics based on their contact with oral mucosa. Additionally, it details methods of fabrication and the necessary biological and hygienic considerations for successful dental applications.
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Pontics seminar
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- 10. Careful diagnostic waxing Orthodontictreatment Proximal stripping
- 11. • Smooth, regularsurface of attached gingiva • Its height and width should allow placement of a pontic. • Free of frenum attachment and be of adequate facial heightIdeal ridge contour
- 12. The incidence ofresidual ridge deformity after anterior tooth loss is high (91%). Anusavice KJ: Phillips’ science of dental materials, 10th ed. Philadelphia, WB Saunders, 1996.
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- 18. *Nemcovsky CE, VidalS: Alveolar ridge preservation following extraction of maxillary anterior teeth. Report on 23 consecutive cases. J Periodontol 67:390, 1996.
- 19. Esthetic Zone • Orthodontic alignment/extrusion •Alveolar architecture preservation technique •Root submerge technique Unesthetic Zone •Orthodontic repositioning •Altering the proximal contours of adjacent teeth
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- 26. 2. On Materialsused
- 27. b) Custome made 3.Method of fabrication
- 28. According to Rosenstielet al Pontic designs are classified into two general groups: • Those that contact the oral mucosa and those that do not. A. Mucosal contact B. No mucosal contact 1. Ridge lap 1.Sanitary (hygienic) 2. Modified ridge lap 2. Modified sanitary (hygienic) 3. Ovate 4. Conical 5. Modified ovate pontic
- 32. “arc-fixed partial denture”, a “modifiedsanitary pontic”, “Perel pontic”.
- 34. SADDLE OR RIDGELAP PONTIC
- 36. MODIFIED RIDGE LAPPONTIC
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- 44. BIOLOGICAL Cleasable tissue surfaces Accessto abutment teeth No pressure on ridge MECHANICAL Rigid; to resist deformation Strong connection; to prevent fracture Metal-ceramic framework; to resist porcelain fracture ESTHETIC Shaped to look like tooth it replaces Appears to “grow” out of edentulous ridge Sufficient space for porcelain
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- 75. A, pontic shouldhave the same incisogingival height (H) as the original tooth. B, Correctly contoured pontic. C, Incorrectly contoured pontic. The shelf at the gingival margin may trap food and create an esthetically unacceptable shadow.
- 91. Wax the internal,proximal, and axial surfaces of the retainers Soften the inlay wax, mold it to the approximate desired pontic shape, and adapt it to the ridge. If a posterior tooth is being replaced, leave the occlusal surface flat because the occlusion is best developed with the wax addition technique Lute the pontic to the retainer and, for additional stability, connect its cervical aspect directly to the master cast with sticky wax. Wax the pontic to proper axial and occlusal (or incisal) contour
- 95. METAL PREPARATION Metal substructureready for airborne particle abrasion and oxidation.
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- 112. Intra oral Viewof the extraction site
- 113. Post operative viewof teeth in occlusion with ceramo-metal fixed partial denture in situ.
- 119. Patient rehabilitated withmetal ceramic FPD
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Editor's Notes
- #11 overly small pontics are unacceptable because they trap food and are difficult to clean.
- #12 which facilitates maintenance of a plaque-free environment. that appears to emerge from the ridge and mimics the appearance of the neighboring teeth Facially, it must be free of frenum attachment and be of adequate facial height to sustain the appearance of interdental papillae.
- #20 Alveolar architecture preservation technique
- #32 Arc-fixed partial denture, modified sanitary, Or Perel pontic It is also less susceptible to tissue proliferation that can occur when a pontic is too close to the residual ridge.
- #38 The modified ridge lap design is the most common pontic form used in areas of the mouth that are visible during function (maxillary and mandibular anterior teeth and maxillary premolars and first molars).
- #39 thin mandibular ridge.
- #41 ranging from controlled regeneration directly after the extraction of the tooth (immediate pontic technique) to plastic surgery (gingival grafting), which is accompanied by tissue conditioning in the course of the subsequent prosthodontic treatment.
- #45 Optimal pontic design
- #48 This was once promoted as a way to improve the appearance of the pontic ridge relationship.
- #51 If the pontic has a depression or concavity in its gingival surface, plaque will accumulate, because the floss cannot clean this area, and tissue irritation will follow. This is usually reversible; when the surface is subsequently modified to eliminate the concavity, inflammation disappears. Therefore, an accurate description of pontic design should be known to the laboratory, and the prosthesis should be checked and corrected if necessary before cementation. Prevention is the best solution for controlling tissue irritation
- #53 Although glazed porcelain looks very smooth, when viewed under a microscope, its surface shows many voids and is rougher than either polished gold or acrylic resin. Nevertheless, highly glazed porcelain is easier to clean than other materials. For easier plaque removal and biocompatibility, the tissue surface of the pontic should be made in glazed porcelain. However, ceramic tissue contact may be contra indicated in edentulous areas where there is minimal distance between the residual ridge and the occlusal table.
- #55 These factors can lead to fracture of the prosthesis or displacement of the retainers. Long span posterior FPDs are particularly susceptible to mechanical problems.
- #57 In fact, narrowing the occlusal table may actually impede or even preclude development of a harmonious and stable occlusal relationship. Like a malposed tooth, it may cause difficulties in plaque control and may not provide proper cheek support. For these reasons, pontics with normal occlusal widths (at least on the occlusal third) are generally recommended. One exception is if the residual alveolar ridge has collapsed buccolingually. Reducing pontic width may then be desired, thereby lessening the lingual contour and facilitating plaque control measures.
- #63 The metal surfaces to be veneered must be smooth and free of pits. Surface irregularities will cause incomplete wetting by the porcelain slurry, leading to voids at the porcelain metal interface that reduce bond strength and increase the possibility of mechanical failure Sharp angles on the veneering area should be rounded. They produce increased stress concentrations that can cause mechanical failure.
- #68 , although long term clinical performance is not yet known.
- #77 However, such pontics then have considerably increased tissue contact and require scrupulous plaque control for long term success.
- #79 For this purpose, an impression is taken of the labial surface of the restoration using a customized tray and a medium viscosity polyether material. The color of the gingiva is determined with an individually fabricated shade guide
- #81 Frequently,
- #82 as precisely as possible in the pontic, and the space discrepancy can be compensated by altering the shape of the proximal areas.
- #83 A discrepancy here can be managed by duplicating the visible mesial half of the tooth and adjusting the size of the distal half.
- #84 These can be altered by the dentist and reglazed if necessary. These include
- #90 Over time, several techniques for pontic fabrication evolved. Prefabricated porcelain facings were very popular for use with conventional gold alloys. As use of the metal ceramic technique increased during the 1970s, prefabricated facings lost their popularity and essentially disappeared. Although an acceptable substitute, custom made metal ceramic facings never gained widespread acceptance.
- #95 there is a distinct 90-degree porcelain metal junction.
- #96 Metal substructure ready for airborne particle abrasion and oxidation.
- #97 because once it is cemented, the restoration will be seen from the facial rather than from the gingival. Excessive gingival porcelain is a common fault in pontic frame work design and may lead to fracture and poor appearance.
- #99 Mark the desired tissue contact and contour the gingival surface to provide as convex a surface as possible. The pontic is now ready for clinical evaluation and soldering procedures, characterization, glazing, finishing and polishing
- #104 in a 200-m-wide zone immediately subjacent to the epithelium (zone A) and in a 200-m-wide central connective tissue portion (zone B).