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 to fill in the missing space.
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.
For larger spaces in the posterior areas, a bar is often added to improve structural integrity, instead of a tooth-shaped void.
You can request a virtual pontic at the time of case submission, in the "Additional Instructions" section. The technician will need to know whether you want the space filled by the pontic to close as the teeth move, or be maintained for future restoration.
Pontics are represented on treatment setups as translucent teeth.
A virtual pontic can be left as an empty void in the aligner, but if you want it to look more like a tooth, there are two main techniques to choose from:
Pontic aligner paint
The inside of the void can be coated with pontic aligner paint (such as Perfect-A-Smile,available in the ClearCorrect Store). This light cure paste comes in varying colors which can be mixed to approximate the shade of adjacent teeth and applied by the doctor or staff prior to delivery of the aligners. This technique is only necessary while the space resembles the shape of a tooth.
Instructions for applying Perfect-A-Smile are available in PDF and video formats.
PVS adhesive material
Instead of painting the inside of the plastic aligner, the pontic void can be filled with a tooth-shaded, vinyl polysiloxane (PVS) adhesive material. While this technique can look good, the material is prone to falling out of the aligners.
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