How to properly design an ovate pontic

Ovate pontics are important for the esthetics of anterior dental work where a tooth is missing. The ovate pontic will give the illusion of a tooth coming out of the gum instead of laying on top of the gum. Maryland bridges in particular are the most challenging areas to do this well.

Clinical photos of ovate pontics

In esthetic dentistry being able to see what you want to accomplish is necessary in order to get there. Therefore, just looking at photo examples of some ovate pontics can really help one in designing them.

Sage advice on ovate pontics

 

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When you design the pontic, do you bone sound the area of the socket? Do you measure the thickness of tissue to bone and then plan the pontic based on that? For example, if there is a 5 mm thickness of tissue to bone, do you plan pontic to come within X mm of the bone and if so, what is the X mm?

Typically I try to get the ovate site as deep as possible.  Too many times, clinicians do not make the pontic site as deep as they should or could and do not take advantage of all the available soft tissue to close gingival embrasures.  Ideally, we would like 1.0 mm between the tissue surface of the ovate pontic and periosteum.  This is why we do not want the ceramist to make ideal ovate
pontic and then we will modify chair-side on fit.  They have no way of determining where soft tissue ends and bone begins.  We can actually prep an ovate site into bone if there is not enough soft tissue to achieve ideal depth but I like to wait 6-8 weeks with provisional in place before definitive impression due to osseous changes that can occur.  I am using an Erbium:YAG laser to create osseous ovate site.  No post-operative discomfort and very predictable healing