Prosthodontics & Occlusion · patient case question
Which pontic design is used ONLY in the mandibular posterior region because it produces phonetic and aesthetic problems in the maxilla?
Patient case: Planning a fixed bridge to replace tooth #30
Patient: Male, 47 years old
Chief Complaint: Wishes to replace a missing lower right first molar.
Background: Tooth #30 was extracted four years ago and never replaced.
Current Findings: Tooth #31 has drifted mesially and is rotated. Tooth #29 is tipped distally. Both proposed abutments are vital, unrestored and periodontally sound. Tooth #3 has supra-erupted slightly into the space.
Show answer and explanation
Correct answer: B. The sanitary (hygienic) pontic
- A. The ovate pontic sits within a surgically or provisionally developed concavity in the ridge and gives the best emergence profile. It is the aesthetic choice for ANTERIOR sites.
- B. CORRECT. The sanitary or hygienic pontic stands clear of the ridge, leaving a space of at least 2 mm beneath it for cleaning. That space is invisible and phonetically irrelevant in the mandibular posterior region, but in the maxilla it is visible and permits air escape that disturbs speech. It is therefore confined to non-aesthetic mandibular posterior sites.
- C. The modified ridge lap contacts only the BUCCAL aspect of the ridge, combining acceptable aesthetics with cleansability. It is the most widely used design.
- D. The conical pontic contacts the ridge at a single point and is used on thin, knife-edge mandibular posterior ridges.
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