Pontics and Bars

For information regarding pontics and bars, refer to the following:

• Definition
• Uses
• Pontics and Bars with ClearCorrect
• Tips

Definition

A pontic is defined as an artificial tooth on a fixed dental prosthesis that replaces a missing natural tooth, restoring its function and esthetics. It usually fills the space previously occupied by the clinical crown of the missing tooth.

A virtual pontic is a tooth-shaped placeholder in an aligner created in the space left by missing teeth. Since the aligner does not cover a tooth in this location, there is a resulting void in the aligner. Fortunately, this void can be painted or filled to create the appearance of a tooth in that space. Pontics are represented on treatment setups as translucent teeth.

A bar has a similar function to pontics. Bars are more commonly used for large spaces, especially in the posterior segments, where several teeth are missing, and aligner functionality and stability is prioritized over patient aesthetics. A bar is represented in the treatment setup as a translucent bar or in some instances, as a zone of flat, higher gum, on the alveolar bone. The display of the bars will be dependent on the software version used when initially planned.

Uses

It is not unusual for a patient undergoing orthodontic treatment with clear aligners to have one or more missing teeth. One of the unique features of treating with aligners is the opportunity for the doctor to provide a virtual pontic or bar to fill in the missing spaces. Filling the missing space with a pontic will provide the patient with a more aesthetically pleasing look during treatment.

For larger spaces on the posterior area the use of bars is ideal as they are able to provide anchorage and structural integrity versus a pontic for a single tooth-shaped void. The bar allows for more plastic material in the interproximal spaces and may help in achieving certain movements, for example when correcting an inclined molar.

These features may also be used when treating multidisciplinary or extraction cases.  

Pontics and Bars with ClearCorrect

Pontics are more commonly used in the anterior region and are automatically placed in treatment plans for open spaces ≥ 3 mm.

Bars are commonly placed in the posterior region automatically in the treatment plan for spaces ≥ 3 mm. We can also accommodate Pontics for pre-molars and molars if preferred, upon request via the "Additional information" section of the Doctor Portal prescription or to the technician during the review of the treatment setup in ClearPilot. 

Additional Information 

ClearPilot

You can also customize your instructions by providing the following details:

• Does the pontic or bar need to be resized as space is closing or opening, or do you just want to maintain the space for a future restoration? Pontics and bars are now resizable every couple of steps (increase or decrease their mesio-distal width).
• Do you want to delay the start of the pontics and bars? They may be introduced at any step of the plan, for example if you are planning for an extraction during treatment.

These two observations have implications on remote monitoring and frequency of appointments: for cases with pontics and bars, especially if they are being resized, need to be monitored monthly.

Aside from the aesthetic advantages of the pontics, they also maintain the vertical dimension and the occlusal contacts, which can contribute to achieving certain movements, for example extrusive force vectors during tooth extrusion. The occlusal contacts should be monitored through treatment to prevent the appearance of interferences.

When using bars, occlusal contacts are not a concern, and the vertical dimension will be controlled by the plastic covering the occlusal surfaces of the teeth in the opposing arch. 

With ClearCorrect you may request a virtual pontic or bar at the time of case submission, in the "Additional Instructions" section of the Doctor Portal prescription. Upon receipt of aligners, the Clinician may paint or fill the space with tooth-like color composite or acrylic. This may be done every other appointment or according to the follow up appointments.

Tips

Most common situations for indicating pontics:

1. Maintain or open a space for an upper lateral incisor.
2. Premolar extraction cases: pontic should resize as the extraction space is closed through treatment.
3. Space maintenance.

Most common situations for indicating bars:

1. Large posterior spaces (two teeth or more).
2. Cases in which a molar needs to be uprighted.

Remember:

1. Monitor your patient closely, especially if pontics and bars are resizing during treatment.
2. Check the occlusal contacts and prevent interferences when using pontics and filling the space with composite or acrylic.
3. Be as specific as possible with the technician in these cases where spaces need to be managed to achieve the best aesthetic result and function.

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