Question:

I’d like to see what do we usually use for filling in an anterior pontic. Can we use composites like Estilite sigma and SE bond ? Or single bond ? Will it last for a week?

Answer:

When working with a pontic that is changing size or growing, an important consideration is how to manage the space around it during treatment. In such cases, the approach is to establish the pontic size and, if more space needs to be created, instruct the technician not to alter the pontic itself. Instead, the space should be opened distally to the pontic. For example, if the pontic is in place for a missing second tooth (lateral incisor), the goal is to create space for restorative work distally, leaving a small gap between the pontic and the adjacent tooth.

If space needs to be made for a lateral incisor where the central incisor and canine are initially touching, the space for the lateral incisor can be opened. However, instead of continuously changing the pontic with every aligner, the size of the pontic should only be altered three times. First, once there is enough space for the pontic, it will be introduced. As the space continues to open, the pontic will change size again, leaving a small gap behind it. This process is repeated one more time for a total of three adjustments.

To facilitate this, clinicians typically create three pontic teeth that can be swapped out between aligners. In practice, six pontics may be made (two for each phase), allowing for a gradual size change of the pontic over the course of the treatment without requiring a new pontic for every single aligner.