Although periodontal factors do not usually have a direct effect on the survival of a fixed
prosthesis, harmony between the
prosthesis and the periodontium is critical otherwise esthetics, the longevity of the
prosthesis and the periodontium will be compromised. A close interdisciplinary relationship between
periodontics and
prosthodontics is therefore necessary to avoid an unsatisfactory treatment outcome, requiring extensive and expensive
retreatment. The design of the
prosthesis, the number and quality of the abutment teeth, the preparation and the
pontic, the occlusion and the material need to be considered when planning prosthodontic treatment. The location of the preparation margin and the contour and emergence profile of the
prosthesis will influence the response of the gingival tissues to the
prosthesis.
Pontic design and cleansibility also contribute to the response of the gingival tissues as well as to the clinical and esthetic outcome. Even an optimal
pontic design will not prevent
inflammation of the mucosa adjacent to the
pontic if
pontic hygiene is not maintained by removal of plaque. Case selection and the patients' ability to carry out adequate
oral hygiene are therefore essential for longevity of the
prosthesis, and regular reviews provide an opportunity for early detection and treatment of failures.