1. Ovate Pontic

2. Pontics -FPD components that replace missing teeth and restore function and apperance compatible with continued oral health and comport

3. Pontic design Tx plan 단계에서 미리 결정 Esthetic ⇔Hygiene Pontic space
Residual ridge contour

4. Biologic considerations
Pressure free ridge contact
Cleansible ridge surface

5. Pontic design classifications
Mucosal contact
-saddle( ↔ridge lap)
-Modified ridge lap
No mucosal contact
-sanitary(fish belly)
-modified sanitary(arch)
-bullet

6. Modified ridge lap pontics
Convex ridge surface-cleansible
Esthetic ploblems
-black triangle
-unnatural emergency profile
Lingual food trap
Possible Phonetic difficulties

7. Ovate Pontics More accurate duplicate of emergency profile
Esthetic and cleansible ridge surface
Positive pressure

8. Historical Background
Porcelain root tip pontic-anecdotal resistance; Reichenbach
Brill has made use of long porcelain roots for fixed bridgework (1 to 2 mm from the base of the extraction socket) apparently with good clinical results
Tissue reaction about porcelain root- histological evaluations by Dewey and Zugsmith(1933); “…revealed tendency of epithelium to cover wound surfaces from the margin, not only in simple extraction wounds but also in empty sockets into which porcelain roots have been imbedded.”

9. smaller extraction wounds were completely covered with a delicate epithelial film in approximately 1 week; Loos and Gross, 1933
Clinical and histologic findings showed the hyperpressure from smooth, polished and glazed convex metal ceramic pontics with excellent plaque control does not introduce inflammation to the adjacent tissues. However, if flossing the areas of hyperpressure does not take place, inflammation is inevitable.”; Tripodakis and Constantinides, 1990

10. Biologic rationale After extraction, fibrin clot begins to form
Epitherial cells migrate from wound margin to center area
Thin layer of epitherial cells diffrentiates into stratified squamous epitherium
Highly polished ovate pontics can act as matrix for stratified squamous epitherium

11. Indication Tooth Fx due to trauma, caries High esthetic demand
Intact buccal plate
Refusal for implant therapy

12. Pontic extention 3mm from most apical tissue in normal ridge
High bone crest-less pontic depth
Low bone crest- more extended pontic is needed(greater tissue support)
Too much extended potic may result in poor tissue healing.

13. Tissue surface preparation
Provisionalization immediate after tooth extraction
Surgical correction of residual ridge
-electrosurgery
-high speed round bur

14. Clinical procedure
-evaluation of pontic space, bone crest level, and esthetic demand
-Dx wax up and provisional restoration
-teeth extraction and adjust of provisional restoration
-epitherialization and remodelling of socket surfaces

15. Case report Name; 김재준(M/45) C.C;이가 흔들린다 P.I ; root Fx on #21
congenital missing
state of #12
diastema(≒2mm)
Tx plan;3-unit FPD(Modified ridge lap)
3-unit FPD(ovate pontic)
Implant on #21