Pontic

A pontic is the artificial tooth component of a fixed dental bridge that spans an edentulous space and replaces the missing natural tooth. The pontic is rigidly connected to retainer crowns or inlays cemented onto adjacent natural teeth or implants, which serve as abutments. Pontics replicate the anatomical form, size, shade, and function of the missing tooth, restoring masticatory efficiency, speech, and aesthetic continuity. The tissue surface of the pontic, where it contacts the edentulous ridge, is designed in configurations such as ridge lap, modified ridge lap, ovate, or hygienic depending on arch location and aesthetic requirements.

Design and material selection are determined by the clinical demands of the site. In the anterior region, the ovate pontic design creates the illusion of a natural tooth emerging from the gingiva by seating into a concavity in the ridge. In the posterior region, modified ridge lap or hygienic designs prioritize cleansability by minimizing lingual tissue contact while maintaining buccal contact for aesthetics. Pontics can be fabricated from porcelain fused to metal, full ceramic or zirconia, gold alloy, or composite resin, with material chosen based on strength, aesthetic demands, and opposing dentition. Bridge longevity depends partly on the patient's ability to clean around and beneath the pontic using floss threaders or interproximal brushes.

In CDT coding, the pontic is billed as a separate unit from retainer crowns. Pontic codes are organized by material: D6240 for porcelain fused to high noble metal, D6241 for predominantly base metal, D6242 for noble metal, D6245 for all-porcelain or ceramic, and D6250 through D6253 for metal alloys. Each retainer crown is coded separately under the corresponding crown code series. When submitting a bridge claim, each unit must be coded individually with the pontic and retainer codes and associated tooth numbers. Most carriers classify fixed bridges as major services subject to preauthorization, waiting periods, and frequency limitations. The clinical narrative should document why a fixed bridge was selected and include radiographic evidence of the abutment teeth's suitability.