A trick to make the pontic stick

From Volume 17, Issue 2, April 2024 | Pages 82-83

Authors

Ian Murphy

BDS, MFDS (RCS Ed), MClinDent, MOrth (RCS Eng), FDS (Orth) RCS, PGCertClinEd, MFDS RCS Ed, MOrth RCS Eng

Post-CCST Orthodontics, Department of Orthodontics, Royal Surrey County Hospital, Guildford

Articles by Ian Murphy

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Abstract

CPD/Clinical Relevance: The reader will learn a method for dealing with the potential for breakages in pontics tied into archwires.

Article

In cases of missing front teeth, having a pontic on the arch wire improves the patient's confidence and is also useful for prosthetic planning. Additionally, if the pontic is aesthetic, then it confirms the space created is ideal.

Common practice for adding a pontic to an archwire involves taking an impression and requesting the lab to produce a pontic of a particular size and shade. The clinician or the lab then attach the bracket to the pontic, and it is tied into the archwire

This method may work quite well, but other times it causes repeated breakages, with the patient having to return to the clinic each time. The reason for these repeated breakages is often instability. The pontics have no gingival support, so when an occlusally directed force occurs, the wire rocks and the pontic can easily debond. Composite resin is strong in compression but weak in tension, therefore any shearing force will cause it to debond easily. Secondly, the lack of gingival support allows the pontic to swing around the wire, especially on undersized wires.

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