Pontic Design and Speech: A Case Study

Influence of Pontic design of anterior fixed dental prosthesis on speech: A clinical case study

Key Terms

Ridge lap pontic: A fake tooth that sits on top of the gums and touches them in the front to look natural, but is shaped to make cleaning easier underneath.
Saddle ridge lap pontic: A type of fake tooth that fully touches the gums on both the front and back, which looks natural but can be harder to keep clean.
Plaque: A sticky, colorless film of bacteria that builds up on teeth and can cause cavities and gum disease if not removed by brushing and flossing.
Edentulous ridge: The part of the gums where teeth used to be but are now missing.

Simplified Case Study

An official term for prosthetic teeth is pontics, but there are many different kinds of pontics, but the main feature being the bridge aspect. Depending on the build and type of bridge pontics, it may affect speech, hygiene routine, aesthetics, or all.

The focus of this study is on a 41-year-old female Chinese patient’s speech pattern with both types of ridge lap pontic (Wan et al., 2021). The study found that with the saddle ridge lap pontic, she was able to pronounce most vowels with no distortions, but speech was distorted for words starting with f, s, and sh. In general, modified ridge lap pontics have more distortions in speech, hence, the patient chose the saddle pontics (Wan et al., 2021).

According to specialists, the modified pontics are more common for hygiene and aesthetics purposes, but may cause longer-lasting speech distortion. While the saddle pontics overlap the edentulous ridge (oral gums) like a saddle, the modified pontics only touch the outside of the ridge, leaving the patient with better access to clean (Wan et al., 2021).

With this in mind, it may be hard to clean under the saddle pontics as plaque may collect between the gums and the pontics. On the bright side, both types of pontics look great from the front, which checks off for the aesthetic aspect of choosing between the two.

Images corresponding to case study

Figure 1: A patient who’s been using a removable partial denture for 4 years to replace missing front upper teeth.

Figure 2: 3D X-ray images (called cone beam CT scans) of the patient’s mouth.

Figure 3. Two partial dentures showing different fake tooth designs — one with a saddle-style and one with a ridge lap-style.

official case study link:
https://www.wjgnet.com/2307-8960/full/v9/i36/11276.htm