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The provision of fixed prosthodontic restorations that meets the patient's functional and aesthetic demands can be challenging, especially in the anterior maxilla. It requires close communication with the technician and knowledge of the available options. This article will outline the options for pontic design and focus on the ovate pontic, which has the potential to provide the most aesthetic outcome. This should equip the practitioner with the knowledge as to which pontic to prescribe if such a challenge arises.
Clinical Relevance: Fixed bridgework is a commonly prescribed prosthesis for the replacement of missing teeth. In order for this to be provided successfully, the practitioner should have a working knowledge of the available options for pontic design. This is especially important in cases where aesthetic demands are high.
Article
A pontic should be designed to provide a functional and aesthetic replacement for a missing tooth or teeth. The location of the missing tooth, either anteriorly or posteriorly, will determine which of these factors has the greater emphasis in an individual situation. Providing an aesthetic anterior bridge may be challenging with respect to giving the pontic a natural appearance. Several factors need to be addressed successfully. These include the size, shape, shade and position of the pontic, as well the emergence profile from the soft tissues.1 In order to mimic the appearance of a natural tooth, the pontic should appear to emerge from the gingivae and support the buccal/labial soft tissue as well as the adjacent papillae. The proximity of the pontic to the mucosa requires that the design should be cleansable and compatible with plaque control and periodontal health. The emergence profile of the pontic is especially important if the bridge is planned in the anterior maxilla and the patient has a high smile line. In many cases, the commonly used pontic designs may not adequately address all the aesthetic challenges.
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