An expectation
of a beautiful smile at the end of orthodontic treatment is a primary concern
for all patients, but most are also concerned with appearance while undergoing
treatment. This is evident in the attempts by manufacturers to meet the esthetic
demand of patients while undergoing orthodontic treatment, including making
metal brackets smaller, developing lingual or "invisible" brackets,
esthetic archwires, plastic brackets and translucent ceramic brackets.
The demand for
adult orthodontics is increasing. It is not unusual for orthodontic patients
to have missing anterior teeth. In some patients, a hopeless anterior tooth
was extracted prior to beginning orthodontic treatment. In some of these patients,
orthodontic treatment alone may solve the problem. However, in others prosthetic
replacement of missing teeth is the most suitable treatment. In such patients,
pre-prosthetic orthodontic treatment often has to be performed to facilitate
the restorative treatment by positioning the teeth for the best possible esthetic
and functional results. It is important to maintain the esthetics of those
individuals undergoing fixed orthodontic treatment. Riding pontics are a good
solution for these patients.
Riding pontic
Riding pontics
are temporary prostheses used during fixed orthodontic treatment in patients
with missing teeth and can be used for any missing teeth. It is especially
good when one or more anterior teeth are missing.
Fabrication
The following are
the steps for fabrication of riding pontics.
Problems with
riding pontics
Labiopalatal rotational
control of the riding pontic is difficult with round archwire, however, movement
can be limited with rectangular archwires.
Bond failure of
the pontic may occur during treatment.
Case Report
A 16-year-old female
reported to the department of Orthodontics with chief complaint of gap between
her upper front teeth region. She had no history of any tooth extraction and
orthodontic treatment. She had a pleasing profile (Figure-1), Class-I molar
relationship with missing maxillary lateral incisors, gap between maxillary
anteriors, deviated maxillary dental midline (left, 2mm) and moderate crowding
in the mandibular anterior region (Figure-2). Nonextraction treatment was
planned. Treatment objectives were closure of midline diastema, regaining
the space for prosthetic replacement of lateral incisors, correction of midline
deviation, relieving the crowding and maintaining the existing Class-I molar
relationship.
The malocclusion
was treated with fixed mechanotherapy (Roth, .022"). Maxillary and mandibular
arches were aligned, leveled and space for the lateral incisors was created.
(Figure-3) Riding pontics were prepared, trial and adjustment was done, and
ligated to the rectangular archwire by stainless steel ligature. (Figure-4
and 5) The esthetic and smile of the patient was however improved after ligating
riding pontics. (Figure-6)
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Figure
3. Intraoral front view before ligation of the riding pontics.
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Figure
4. Riding pontics.
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Figure
5. Intraoral front view with riding pontics in the place.
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Figure
6. Extraoral front view of patient with smile before and after ligation
of riding pontics.
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Conclusion
Riding pontic can
be considered as an esthetic aid for the orthodontic patients with missing
one or more anterior teeth. It helps to improve patient's esthetic and smile
during orthodontic treatment.
