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A COMPARATIVE STUDY ON TISSUE RESPONSE
UNDER THE RIDGE LAP AND MODIFIED
RIDGELAP PONTICS.
Prepared by
MAJOR NADIA JAHAN
TRAINEE
GRADING IN PROSTHODONTICS
DEPARTMENT OF PROSTHODONTICS
2021 - 2022
ARMED FORCES MEDICAL INSTITUTE
DHAKA CANTONMENT, DHAKA
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Declaration
I humbly proclaim that this dissertation titled “A comparative study on
tissue response under the ridge lap and modified ridgelap pontics” has
been accomplished by me and it had not been previously presented for any
higher degree. The work was carried out in the department of Prosthodontics,
Military Dental Centre Dhaka, under the guidance and supervision of Col Md
Tariquzzaman, Classified Specialist and Head of the Department of
Prosthodontics, Military Dental Centre Dhaka.
Dated:
Armed Forces Medical Institute
Dhaka Cantonment, Dhaka.
----------------------------------------Major Nadia Jahan
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Forwarding
Certified that Major Nadia Jahan carried out this research titled „„A
Comparative Study On Tissue Response Under The Ridge Lap
And Modified Ridgelap Pontics” prepared this dissertation under my
direct supervision. I have found the work and the dissertation
satisfactory for partial fulfillment of the requirements of the Diploma
in Prosthodontics Examinations of Bangladesh University of
Professional (BUP).
_______________________________
Signature of Supervisor
Md Tariquzzaman, D-Prostho,FCPS
Col
Head of the Department of Prosthodontics
Military Dental Centre Dhaka
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REMARKS
-------------------------------------------------Signature of Head of the Department
Md Tariquzzaman, D-Prostho,FCPS
Col
Head of the Department of Prosthodontics
Military Dental Centre Dhaka
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REMARKS
---------------------------------------------------Brig Gen Md Abdur Rab, FCPS
Commandant
Military Dental Centre Dhaka
Dhaka Cantonment, and
Acting Consultant Dental Surgeon General
Directorate General Medical Services
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Dedicated
To
My beloved parents
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ABSTRACT
Background: Edentulous space are frequently restored by fixed partial
dentures (FPD), but this may also contribute to various problems. The pontic
or an artificial tooth is the main component of a fixed partial denture .
The function of pontic is to withstand masticatory load, to permit effective
oral hygiene, preserves underlying residual mucosa and adjacent abutment
teeth thus provides esthetics as well as restore function.
Objective: To observe the tissue response under the ridge lap and modified
ridgelap pontic.
Materials and methods: This study was conducted in the department of
Prosthodontics, Military Dental Centre Dhaka. A total number of 40 patients
were selected with the history of missing first mandibular teeth reporting in
the Department of Prosthodontics, MDC Dhaka. The patients completed
questionnaire regarding their age, sex, condition of the tooth. The teeth was
categorized into two groups:Group- I: consists 20 patients with ridgelap
pontics, Group- II: consists 20 patients with modified ridgelap pontics.
Results: 40 diagnosed mandibular 1st molar missing patients were included
in this study. All these patients were evaluated under 2 parameters. The
parameters are the condition of mucous membrane and the condition of
abutment tooth. In case of group A maximum patients were found in grade IV
whereas in group B maximum patients were found in grade I. The chi-square
test was done as the test of significance and the p value was <0.05 which was
statistically significant.
Conclusion: After completion of this study it is concluded that the tissue
response with the modified ridgelap pontic of fixed partial denture in 1st
molar missing tooth achieved better success regarding fixed partial denture.
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Table of Content
Chapter and Section No
Page No
Acknowledgement
XIV
Chapter I: Introduction
1:1.0 Background
2-3
1:2.0 Rationale of the study
4
1:3.0 Research question
5
1:4.0 Objectives
6
1:5.0 Review of literature
7-9
CHAPTER II: Materials and Methods
2:1.0 Type of Study
11
2:2.0 Place of study
11
2:3.0 Period of study
11
2:4.0 Study population
11
2:5.0 Sample Size
11-12
2:6.0 Sampling method
12
2:7.0 Inclusion criteria
12
2:8.0 Exclusion criteria
13
2:9.0 Operational definition
13
2:10.0 Grouping
13
2:11.0 Equipment
14
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2:12.1 Main outcome variable
14
2:12.2 Independent variable
15
2:13.0 Study procedure
15-16
2:14.0 Flowchart
17
2:15.0 Ethical consideration
17
2:16.0 Data collection technique
18
2:17.0 Data analysis
18
Chapter III: Results
19-25
Chapter IV: Discussion
4:1.0 Discussion
26-30
4:2.0 Limitation
31
4:3.0 Conclusion
32
4:4.0 Recommendations
33
References cited
34-37
Appendices
Appendix –I
Data collection sheet
XV-XVII
Appendix –II
Consent form
XVIII-XX
Appendix-III
Ethical clearance
XXI-XXIX
Appendix-IV
Figure
XXIX-XXX
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List of Tables
Table No
Table-1
Title
Page
Distribution of patients according to age.(n=40)
Table -2 Distribution of patients between group A and B
20
21
regarding condition of mucous membrane observed
after 6 weeks, 12 weeks and 6 months
Table -3 Distribution of patients between group A and B
regarding condition of abutment teeth observed
after 6 weeks, 12 weeks and 6 months
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List of Figures
Figure
Title
Page
No
Figure-1
Distribution of patients of group A
regarding
22
condition of mucous membrane observed after 6
months
Figure-2
Distribution of patients of group B
regarding
23
condition of mucous membrane observed after 6
months
Figure-3
Dental spoon excavator
XXIX
Figure-4
Dental mirror
XXIX
Figure-5
Dental periodontal probe
XXX
Figure-5
Dental caries probe
XXX
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Abbreviation
FPD- Fixed partial denture
Co-Cr- Cobalt Chromium
GI- gingival index
CI- calculus index
PD- probing depth
GR- gingival recession
TM- tooth mobility
SD- Standard deviation
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Acknowledgement
First of all,I am grateful to Almighty Allah, the most gracious, the most
merciful, for enabling me to complete this dissertation.
I wish to express my heartfelt gratitude to my supervisor Col Md.
Tariquzzaman,D-Prostho,FCPS,Classified Specialist in Prosthodontics,
Military Dental Centre Dhaka. I am indebted to him for guiding interest,
intellectual inputs, constant supervision, valuable suggestions, advice and
whole hearted co-operation from the beginning to end of the study.
With my great pleasure and heartfelt gratitude,I acknowledge the scholarly
guidance and constructive suggestion provided by Brig Gen Md Abdur Rab,
FCPS,Commandant Military Dental Centre Dhaka and Acting Consultant
Dental Surgeon General,Directorate General Medical Services for his
inspiration and valuable suggestions, patronage and provision of excellent
working and learning environment in the preparation and completion of this
dissertation.
I want to express my sincere gratitude to Lt Col S.M.Nazrul Islam,
PBGMS,MPH,D-Prostho,Graded Specialist in Prosthodontics Military Dental
Centre Dhaka. I am grateful to him for his encouragement,inspiration,
valuable suggestions, advice and co-operation till the end of the study.
Last but not the least, I offer my sincere thanks and appreciation to all of my
senior and junior colleagues of Military Dental Centre Dhaka, who have gone
unmentioned, for their support and assistance in my endeavors.
Major Nadia Jahan
Trainee
Grading in prosthodontics
Department of Prosthodontics
Military Dental Centre
Armed Forces Medical Institute
Dhaka Cantonment, Dhaka.
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CHAPTER- I:
INTRODUCTION
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1:1.0 Background
The pontic or an artificial tooth is the main component of a fixed
partial denture. The pontic is defined as “the artificial tooth suspended from
the abutment teeth.1 According to the glossary of prosthodontic terms a
pontic is defined as “an artificial tooth on a fixed partial denture that
replaces a missing natural tooth restores its functions, and usually fills the
space previously occupied by the clinical crown.2
In this role, the pontic should restore function, provide esthetics and
comfort, be biologically acceptable, permit effective oral hygiene, and
preserve underlying residual mucosa.3
There are various types of pontics used in fixed prosthodontics. According
to shape the pontic can be divided into ridge lap, modified ridge lap,
sanitary, modified sanitary, saddle, modified saddle, conical, bullet and
heart shaped pontic. According to material a pontic may be classified in all
metal, metal and porcelain, combination of metal and resin.4
The Pontic, as it mechanically unifies the abutment teeth and covers a
portion of the residual ridge, assumes a dynamic role as a component of the
prosthesis.William Howard Leno and Clarence Puri in 1982 gave the
standards of pontics design which stated that: tissue surface of the pontic
should be covered for cleaning, pontics should never have positive pressure
on the underlying tissue, pontics and connectors must be of adequate built to
withstand occlusal forces and also restore esthetics .Commonly used pontic
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designs are ridge lap pontic, modified ridge lap pontic,sanitary
pontic,conical pontic, and ovate pontic.5
In ridge lap pontic reduction of the surface area does not significantly
improve hygiene underneath the pontic, because the basal contour
remains concave, unsuitable to provide a tight contact to the dental floss.6
The pontic should not be designed to pressurize the alveolar mucosa
as it may produce ulceration.7,8 Previous concepts of close tissue adaptation
are not followed lately. It should be remembered that patient’s maintenance
(flossing) is more important than the pontic design.9,10
The aim of this study was to observe tissue response under the ridge lap and
modified ridgelap pontic and condition of interdental papilla under the
connector of fixed partial denture and to evaluate periodontal status of the
abutment teeth.
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1:2.0 Rationale of the study
Ridgelap pontics and modified ridgelap pontics are two types of fixed
partial denture that are used for replacing missing teeth. After insertion of
the partial denture the reaction of mucous membrane beneath the tissue
surface and condition of abutment teeth is very important for patients
comfort and overall success of the treatment. This study will help
prosthodontists to understand the tissue response under the ridgelap and
modified ridgelap pontics with an aim to choose a better type of fixed
partial denture to maintain patients good oral hygiene, comfort and better
life.
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1:3.0 Research question
The tissue response is better under the ridge lap or modified ridgelap
pontic?
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1:4.0 Objectives
1:4.1 General objective:
To observe the tissue response under the ridge lap and modified
ridgelap pontic
1:4.2 Specific objectives:
1. To evaluate the condition of mucous membrane beneath the tissue surface
of pontic
2. To evaluate the condition of interdental papilla under the connector of
fixed partial denture
3. To assess the periodontal status of the abutment teeth
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1:5.0 Review of Literature
Stein RS (1966) was found that the tissue response under modified ridgelap
pontic is better than ridgelap pontics.The study initially recruited 15 healthy
volunteers who have missing mandibular first molar teeth.After 6 weeks
follow up visit there were 20.8% patients in grade II and 13.8% patients in
grade IV in ridgelap pontics.11
In another study Grisapin (1979) identified that the tissue response in
modified ridgelap is better after one month follow up. He found tissue color
was normal and there was no overt sign of inflammation or ulceration.12
Hirshberg SM (1972) described that the gingival index was created for the
assessment of the gingival condition and records of the qualitative changes
in gingiva.It scores of grade I to grade IV.In his research he found 8 patients
in grade I, 46 in grade II, 18 in grade III and 4 in grade IV in case of ridge
lap pontic after 12 months follow up visit. Hirshberg SM (1972) also
identified that modified ridgelap pontic was better than ridge lap pontic in
maintaining mucosal health since inflammation developed beneath ridgelap
pontic, changing the modified ridgelap pontics to the ridgelap type
alleviated inflammation.13
According to the condition of the abutment teeth the group B patients had
no different response and in group A patients have very minor response in 6
week up visit. Therefore in our study suggested 6 week follow up visit.
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In a similar study, Tolboe H et al. (1998) identified that five patients
developed hypertrophy and pocket formation around the pontics. According
to the condition of the abutment teeth it was graded from grade I to IV.Mild
to moderate inflammation in the mucosa was estimated with both the
modified ridgelap and ridgelap pontic and the mucosal exudation was found
when the oral hygiene was omitted in the pontic area.14
Chester S. Handelman measured tissue reaponse of 120 adult Caucasian
and African-American subjects divided into four groups of 30 by gender and
race. All the groups have different tissue response due to change in pontic
design.Tissue color and sign of inflammation are also useful tool in
detecting tissue response under pontic area.15
Edmund cavazos jr selected 28 patients,among them 9 are grede I and 7 are
in grede II in ridgelap type pontic and 7 patients are grade ii and 5 are grade
I in modified ridgelap pontic.Accumulation of food debrish was more when
pontics are ridgelap and biopsy shows moderate inflammation with the
dissolution of basal layer.16
Allison,J,R and Bhatia investigate into the changes occuring in the oral
mucousa beneath different pontics.Tissue respond dramatically to ridgelap
and in lesser degree in modified ridgelap.In order to maintain a completely
healthy and hygienic condition for fpd, pontic design with minimal
adaptation to tissue is preferable.17
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Podshadley,A G measured gingival response to different type of pontic
designs have identified when properly adapted ridgelap pontics were used, a
tissue change was produced under 75% of pontics.25 percents of pontics
that are shaped to modified ridgelap had evidently favorable tissue changes.
The tissue changes were proportionately increased as a amount of adaption
of pontic to ridge increased.18
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CHAPTER- II:
MATERIALS AND METHODS
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2:1.0 Study design
This was a observational study.
2:2.0 Place of study
The study was conducted in the Department of Prosthodontics in Military
Dental Centre Dhaka.
2:3.0 Period of study
1 February 2021 to 31 January 2022
2:4.0 Study population
Patients come seeking treatment for their missing mandibular first molar
teeth in the department of Prosthodontics, Military dental centre Dhaka will
be taken.
2:5.0 Sample size
To determine the sample size for this proposed study, the following formula
was used:
Z2 P(1-P)
n=
d2
Here,
n = Desired sample size
Z = Standard normal deviate usually set at 1.96 which corresponds to
95% confidence interval (value for error)
P = Proportion of occurrence in the target population (Taken as 50%)
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q = 1 – p = (1 – 0.5)
d = Degree of accuracy with 5% error = 0.05
So, using above formula, the expected sample size is
(1.96)2 (0.5)(1 – 0.5)
n=
= 384 (Approx)
2
(0.05)
Therefore, the sample size for this study was 384.
But, due to time limitation and resource constrain, total 40 patients were
taken from Military Dental Centre Dhaka, Dhaka Cantonment.
2:6.0Sampling method
Purposive sampling.
2:7.0 Inclusion criteria
1.
Patients having mandibular 1st molar missing with ideal abutments on
both sides as well as having class-1 occlusion.
2.
Good systemic health.
3.
No history of musculoskeletal or neurological disorders.
4.
No history of orthodontic treatment.
5.
No history of malignant disease, major or minor surgery in the
orofacial region in the past 3 months.
6.
Patient willing to participate in the study
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2:8.0 Exclusion criteria
1. Patients who have periodontally compromised abutment
2. Patients with tilted abutment
3. Patients with deformed ridge
4. Patients have edentulous area with recently extracted socket
5. Patients with major psychological disorders
6. Unwilling to participate.
2:9.0 Operational definition:
Pontics: An artificial tooth on a fixed partial denture that replaces the
missing tooth restores its function and usually fills the space previously
filled by the natural crown. They must restore function, be hygienically
maintainable, be biologically and esthetically acceptable and be comfortable
to the patients.19
Ridgelap pontics: A pontic which resembles natural tooth and is designed to
adapt closely to the ridge that compress the tissue surface.19
Modified ridgelap pontics: A pontic which is designed to reduce the tissue
contact and have no or pin point contact to the tissue.19
2:10.0 Grouping:
Total patients were divided into two groupsGroup A: consists 15 patients with ridgelap pontics
Group B: consists 15 patients with modified ridgelap pontics
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2:11.0Equipment:
● Mouth mask;
● Sterile gloves;
● Dental mirror;
● Dental unit;
● Football or wheel shaped diamond,
● Flat ended tapered diamond,
● Finishing stones, explorer,
● Periodontal probe,
● Hatchet,
● Chisel;
● Gingival retraction cord,
● Silicone impression material,
● Temporary cementing material.
2:12.1 Main outcome variable:
Two variables were assessed.
● Condition of mucous membrane will be graded under the grading
of Carrenza 1996
● Condition of abutment teeth will be graded under the grading of
Carrenza 1996
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2:12.2 Independent variable:
● Age
● Sex
● Educational status
● Monthly income
2:13.0 Study procedure
In this study, the sample was made of 30 patients, distributed into 2 groups.
One of the groups was treated with ridgelap pontic and another group with
modified ridgelap pontic. The subjects were selected according to the above
mentioned inclusion and exclusion criteria. First teeth were prepared for a
metal-ceramic crown. Gingival retraction cord was used to expose the
margin. Impression was taken by A-silicon impression material. Model was
prepared from the impression and send to laboratory for fabrication of
acrylic bridge prosthesis. Before glazing, the prosthesis was tried on
patient’s mouth and error was corrected,if any. The prosthesis was inserted
by temporary cementing material for follow up. A standardized structured
data collection sheet was used to collect necessary information of the study
subjects, which include (a) History of the patients: A detailed history of
particulars of the patient, socioeconomic status was taken.(b) Clinical
examination: condition of the mucous membrane and abutment teeth was
noted according to grading in the data sheet.
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The patients will be evaluated at four different points: at the beginning of
the treatment, as well as 6 week, 12 weeks and 6 months after initiation of
treatment.Patients were graded according to condition of mucous membrane
Grade-I: Healthy gingiva
Grade-II: Mild inflammation, slight change color, slight edema, no bleeding
on probing.
Grade-III: Moderate inflammation, redness, edema and bleeding on probing
Grade-IV: Severe inflammation, marked redness and edema, ulceration,
tendency to spontaneous bleeding.20
And also patients were graded according to condition of abutment teeth
Grade-I: No mobility and no pocket depth.
Grade-II: 2-3 mm of sulcus depth and slightly more than normal.
Grade-III: 3-4 mm of sulcus depth and moderately more than normal
mobility.
Grade-IV: Above 4mm of sulcus depth severe mobility to faciolingualy and
mesiodiastaly.20
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2:14.0 Flow chart showing the sequence of task:
Study population
↓
Sample (inclusion and exclusion criteria)
↓
Preparation of questionnaire and data Sheet
↓
Clinical and radiographic examination
↓
Study procedure
↓
Data Collection through structured questionnaire
↓
Data analysis
↓
Results
2.15.0 Ethical consideration
Ethical clearance was obtained from the Research Committee of Military
Dental Centre (MDC) Dhaka. Permission to use the records will be obtained
from the Department of Prosthodontics, Military Dental Centre Dhaka.
Written informed consent was obtained from the patients or legal guardian
for this study. Patient confidentiality was strictly maintained. No names,
address or contact details of the patients was divulged.
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2:16.0 Data collection technique
A standardized structured data collection sheet (Appendix-A) was used to
collect necessary information of the subject group. Data sheet included all
of the variables regarding to the study.
2:17.0 Data analysis
Data will be stored and analyzed using the Statistical Package for Social
Science (SPSS version 20) and descriptive statistics to be presented with
standard statistical tests (chi-square tests for parametric variables and
unpaired Student’s t-test). P (probability) and Z values will also be
calculated.
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CHAPTER- III:
RESULTS
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Results:
Total 40 diagnosed patients who have missing first molar teeth were
selected from the Department of Prosthodontics of Military Dental Centre
Dhaka irrespective of age and sex following some inclusion and exclusion
criteria.20 patients were treated with fixed partial denture having ridgelap
pontic and were included under group A. Rest 20 patients were treated with
fixed partial denture having modified ridgelap pontic and were included
under group B.The results were furnished in tables according to the data
found.
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Table-I: Distribution of patients according to age. (n=40)
Age (Years)
Number of patients
Total Percentage%
Male
Female
21-25
6
3
9
22.5%
26-30
5
6
11
27.5%
31-35
5
5
10
25%
36-40
6
4
10
25%
22
18
40
Total
100%
Table-I showed that among 40 patients, majority 11 (27.5%) patients were in age group
of 26-30.
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Table II: Distribution of patients between group A and B regarding condition of
mucous membrane observed after 6 weeks, 12 weeks and 6 months (n=40)
Grades
6 weeks
Group A
No
%
12 weeks
Group B
Group A
No
%
No
%
6 months
Group B
No
%
GroupA
Group B
No
%
No
%
0
00
16
80%
Grade I
1
5%
1
5%
1
5%
15 75%
Grade II
2
10% 1
5%
1
5%
5 25%
2 10%
4
20%
Grade III
10
50% 8
40%
8 40%
0 00
6
30%
0
00
Grade IV
7
35% 10
50%
10 50%
0 00
12
60%
0
00
X2
17.633
32.917
34.667
P value
0.001
0.001
0.001
Table-II showed among 40 patients maximum 60% are grade IV after 6 months interval
in group A and 80% are grade I in group B after 6 months interval.
Data were analyzed using chi-square Test
Significant = P<0.05, Not significant= P>0.05
Group A= Ridge lap pontic, Group B=Modified ridge lap pontic
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Figure-I: Distribution of patients of group A regarding condition of mucous
membrane observed after 6 months (n=20)
Group A
Grade I
Grade II
Grade III
Grade IV
Figure -I: showed that among 20 patients, majority 12 patients grade IV after 6 months
interval.
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Figure-II: Distribution of patients of group B regarding condition of
mucous membrane observed after 6 months (n=20)
.
Figure - II showed that among 20 patients, majority 16 patients grade I after
6 months interval
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Table III: Distribution of patients between group A and B regarding
condition of abutment teeth observed after 6 weeks, 12 weeks and 6
months.(n=40)
Grades
6 weeks
12 weeks
6 months
Group A
Group B
Group A
Group B
NO
No
No
No
%
%
%
%
Group A
No
Group B
%
No
%
Grade I
3 15%
9 45%
3 15%
10 50%
2 10%
9 45%
Grade II
6 30%
7
35%
5 25%
4 20%
5 25%
4 20%
Grade III
4 20%
2 10%
7 35%
4 20%
5 25%
5 25%
Grade IV
7 35%
2
5 25%
2 10%
8 40%
2 10%
X2
P value
10%
6.521
8.063
0.089
0.045
8.166
0.043
Table-III showed among 40 patients maximum 40% are grade IV after 6 months interval in group
A and 45% are grade I in group B after 6 months interval.
Data were analyzed using chi-square Test
Significant = P<0.05Not significant= P>0.05
Group A= Ridge lap pontic, Group B=Modified ridge lap pontic
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CHAPTER- IV:
DISCUSSION
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4:1.0 Discussion
This was a comparative observational study carried out to evaluate the
condition of mucous membrane in patients having ridgelap or modified
ridgelap pontic. This study was conducted in the Department of
Prosthodontics, Military Dental Centre Dhaka from 1 February 2021 to 31
January 2022. The patients of the study were selected from the patients who
have attended in the department of Prosthodontics for the treatment of their
missing teeth. In group A, the pontic forms a large concave contact with the
ridges. The tendency of concavity of pontic was greater in the under surface
and it had a slightly larger area of tissue contact.
In group B, the pontic does not contact the lingual aspect of the ridge, while
facially it is in contact with the ridge. It was made convex in all tissue
contacting surface and the gingival surface of the pontics overlaps only the
buccal surface of the ridge.
In present study there were 5% patients in grade I, 10% patients in grade II,
50% patients in grade III and 35% patients in grade IV in ridgelap pontics
after six weeks follow up visit.And 5% patients in grade I, 5% patients in
grade II, 40% patients in grade III and 50% patients in grade IV in modified
ridgelap pontics after six weeks follow up visit.The p value was .001 which
was significant.
In a similar study Stein RS (1966) was found that the tissue response under
modified ridgelap pontic is better than ridgelap pontics. The study initially
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recruited 15 healthy volunteers who have missing mandibular first molar
teeth. After 6 weeks follow up visit there were 20.8% patients in grade II
and 13.8% patients in grade IV in ridgelap pontics.11
In present study there were 5% patients in grade I, 5% patients in grade II,
40% patients in grade III and 50% patients in grade IV in ridgelap pontics
after 12 weeks follow up visit.And 75% patients in grade I, 25% patients in
grade II, 00% patients in grade III and 00% patients in grade IV in modified
ridgelap pontics after 12 weeks follow up visit.The p value was .001 which
was significant.The tissue response after 12 weeks of the modified ridgelap
pontic was favourable, 75%patients(maximum) were grade I. Tissue color
was normal and there was no overt sign of inflammation or ulceration.
In another study Grisapin (1979) identified that the tissue response in
modified ridgelap is better after 12 weeks follow up. He found tissue color
was normal and there was no overt sign of inflammation or ulceration.12
In present study there were 00% patients in grade I, 10% patients in grade
II, 30% patients in grade III and 60% patients in grade IV in ridgelap
pontics after 6 months follow up visit.And 80% patients in grade I, 20%
patients in grade II, 00% patients in grade III and 00% patients in grade IV
in modified ridgelap pontics after 6 months follow up visit.The p value was
.001 which was significant.
Hirshberg SM (1972) described that the gingival index was created for the
assessment of the gingival condition and records the qualitative changes in
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gingiva. It scores of grade I to grade IV.In his research he found 8 patients
in grade I, 46 in grade II, 18 in grade III and 4 in grade IV in case of ridge
lap pontic after 6 months follow up visit. Hirshberg SM (1972) also
identified that modified ridgelap pontic was better than ridge lap pontic in
maintaining mucosal health since inflammation developed beneath ridgelap
pontic and changing the modified ridgelap pontics to the ridgelap type
alleviated inflammation.13
In present study, patients were evaluated between the groups regarding
condition of abutment teeth. In case of group A, 3 patients were found in
grade I, 6 in grade II, 4 in grade III and 7 in grade IV whereas in group B 9
patients were in grade I, 7 were in grade II, 2 in grade III and 2 patients
were found in grade IV, after 6 weeks. The chi-square test was done as the
test of significance and the P value was >0.05 which was statistically not
significant. After 12 weeks interpretation 3 patients were found in grade I, 5
in grade II, 7 in grade III and 5 were found in grade IV respectively in case
of group A, whereas 10 patients were found in grade I, 4 were grade II, 4
were grade III and 2 patients were found in grade IV in case of group B.
The chi-square test was done as the test of significance and the P value was
<0.05 which was statistically significant. After 6 months interpretation in
group A 2 patients were found in grade I, 5 were in grade II, 5 were in grade
III and 8 were in grade IV respectively, whereas in group B grade I had 9
patients, grade II had 4 patients and there were 5 patients in grade III and 2
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patients were grade IV respectively. The chi-square test was done as the test
of significance and the p value was <0.05 which was statistically
significant. According to the condition on the mucous membrane in relation
to the ridgelap surface of the pontic the group B patients has shown better
response and tissue tolerance then group A patients. Therefore in our study
modified ridgelap pontic had better result compare to ridgelap pontic.
In a similar study, Tolboe H et al. (1998) identified that five patients
developed hypertrophy and pocket formation around the pontics. According
to the condition of the abutment teeth it was graded from grade I to IV.Mild
to moderate inflammation in the mucosa was estimated with both the
modified ridgelap and ridgelap pontic and the mucosal exudation was found
when the oral hygiene was omitted in the pontic area.14
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4:2.0 Limitation of the study
The findings of this study cannot be generalized to the whole population as
the sample size was not large enough and the data of this study were
collected from single centre , Military Dental Centre Dhaka.
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4:3.0 Conclusion
After completion of this observational comparative study it is concluded
that the tissue response with the modified ridgelap pontic in 1st molar
missing tooth enhanced the condition of the mucous membrane beneath the
tissue surface of the pontic, condition of interdental papillae, condition of
the abutment tooth and mucosa overlying the edentulous ridge and achieved
better success regarding fixed partial denture.
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4:4.0 Recommendations
● This study would suggest that the clinician should evaluate the abutment
teeth carefully during examination..
● The study should be conducted on a long-term basis with large sample
size to evaluate the causes of abutment tooth condition.
● Clinician should care full in work like mobility examination, periodontal
probing.
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REFERENCES CITED
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1.
Faucher RR, ‘A system for localizing pontics’,The Journal of
Prosthetic Dentistry 1984, vol.52,pp 643–7.
2.
Pine B, ‘Pontics for gold-acrylic resin fixed partial dentures.,The
Journal of Prosthetic Dentistry 1962,vol 12,pp 347–8.
3.
Kaplan M. Fiji, ‘Race and Pontics in an Island State. MICHAEL C.
HOWARD.AmericanEthnologist1994’; 21: 1032–3.
4.
Becker CM,‘Current theories of crown contour, margin placement
and pontic design’, Journal of Prosthodontics Dentistry 2005, vol.
93, no. 2, pp. 107-114.
5.
Binkley TK, Noble RM, Wilson DC. Natural teeth pontics for a cast
metal resin-bonded prosthesis. J Prosthet Dent 1986;56: 531–5.
6.
Kim TH, Cascione D, Knezevic A, Nowzari H. Restoration
using gingiva-colored ceramic and a ridge lap pontic with
circumferential pressure: a clinical report. J ProsthetDent 2010;
104:71–6.
7.
Behrend DA,‘The design of multiple pontics’, Journal of
Prosthondontic Dentistry 1981, vol. 46, no. 6, pp. 634-38.
8.
Crispin BJ,‘Tissue response to posterior denture base-type pontics’,
Journal of Prosthondontic Dentistry 1979, vol. 42, no. 3, pp 257-61.
9.
Silness J, Gustavsen F, Mangersnes K , ‘The relationship
between pontic hygiene and mucosal inflammation in fixed
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bridge recipients’, Journal
of Periodontal Research 1982, vol.
17, pp. 434-39.
10.
Thayer KE, ‘Pontics and pontic form’, In: Fixed prosthodontics
1984, Chap. 16. Pp218-27.
11.
Stein RS (1966), ‘Fixed partial denture’, Journal of Prosthetic
Dentistry, vol. 16, no. 2, pp 251-85.
12.
Grisapin,Anthony HLT (1983),‘ A sanitary arc-fixed partial denture:
concept and technique of pontic design’, Journal of Prosthondontic
Dentistry, vol. 50, no. (3): 338-41.
13.
Hirshberg SM (1972), ‘The relationship of oral hygiene to embrasure
and pontic design-A preliminary study, vol. 27, no. 1, pp 26-38.
14.
Tolboe H, Isidor F, Jorgensen BE, KaaberS (1987), ‘Influence of oral
hygiene on the mucosal conditions beneath bridge pontics’, Scand J
Dent Res, vol. 94, pp 475-82.
15.
Barnes CM, Russell CM,Chester S.Handelman Reinhardt RA (2005),
‘Comparison of irrigation to floss as an adjunct to tooth brushing:
Effect of bleeding, gingivitis and supragingival plaque’, J Clin Dent,
vol. 16. Pp 71-77.
16.
Cavazos E (1968),’ Tissue response to fixed partial denture pontics’,
Journal of Prosthondontic Dentistry, vol. 20, no. 2, pp 143-53.
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17.
Allison,J,R and Bhatia,Behrend DA (1981), ‘The design of multiple
pontics’, Journal of Prosthondontic Dentistry, vol. 46, no. 6, pp 63438.
18.
Podshadely AG (1968), ‘Gingival response to pontics’, Journal of
Prosthondontic Dentistry, vol.19, no. 1, pp 51-57.
19.
Deepak N (2003), ‘Pontic design’ In: Textbook of prosthodontics, 1st
ed., pp 506-25. 12.
20.
Caranza RA (1996), ‘Gingival index and plaque index’, Clinical
periodontology, 8th ed. pp 63-68.
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CHAPTER- V:
APPENDICES
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Data Collection Sheet
SL. NO.
Date:
Title: “A COMPARATIVE STUDY ON TISSUE RESPONSE UNDER THE RIDGE
LAP AND MODIFIED RIDGELAP PONTICS.”
Investigator: Major Nadia Jahan, Grading Trainee, Department of Prosthodontics, Military Dental
Centre Dhaka, Dhaka Cantt.
Supervisor: Col Md Tariquzzaman,D-prostho,FCPS,Classified Specialist in Prosthodontics.Military
Dental Centre Dhaka. Dhaka Cantt
Place of study: Military Dental Centre Dhaka, Dhaka Cantt.
Patient’s data
A.Assessment of the Patient:1.
Patient’s name
:
2.
Address & Contact number
:
3.
Age and sex
:
4.
Reg no
:
5.
Place of resident
:
6.
Chief complaints
:
7.
Etiology of missing
tooth/teeth
8.
Medical history
8



Rural
Semirural
Urban
:




Extraction
Congenital missing
Exfoliation due to trauma
Others
:







HTN
DM,
Anaemia
Hepatic disease
Renal disease
Bleeding disorder
Respiratory disease, etc
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9.
Clinical Findings:a) Condition of mucous
membrane
b) Condition of
abutment teeth
10.
:
:
11.
Radiological Findings
:
a) OPG
b) IOPA view
Reason for seeking treatment
12.
Diagnosis
Grade-I : Healthy gingival
 Grade-II : Mild inflammation, slight
change color, slight edema, no
bleeding on probing.
 Grade-III : Moderate inflammation,
redness, edema and bleeding on
probing
 Grade-IV : Severe inflammation,
marked redness and edema,
ulceration, tendency to spontaneous
bleeding.
 Grade-I : No mobility and no pocket
depth.
 Grade-II : 2-3 mm of sulcus depth
and slightly more than normal.
 Grade-III : 3-4 mm of sulcus depth
and moderately more than normal
mobility.
 Grade-IV : Above 4mm of sulcus
depth severe mobility to faciolingualy
and mesiodiastaly



Poor aesthetics
Difficulties in mastication
Speech problem
:
…………………..
………………………………..
Date:
Signature of data collector
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Informed Written Consent Form
1.
Protocol ID:
2.
Patient ID:
3. Title of the study:: “A COMPARATIVE STUDY ON TISSUE
RESPONSE UNDER THE RIDGE LAP AND MODIFIED RIDGELAP
PONTICS.”.
4.
Investigator`s name: Major Nadia Jahan, Grading Trainee, Department of
Prosthodontics, Military Dental Centre Dhaka, Dhaka Cantt.
5.
Institution/organization: Military Dental Centre Dhaka, Dhaka Cantt.
6.
Purpose &nature of the study: The purpose of the study to assess the
periodontal condition of natural teeth in contact with the removable partial
denture.
7.
Selection of the participant: The study population is patients present in
outdoor and the department of Prosthodontics, Military Dental Center, Dhaka
Cantt.
8.
Expectation from and involvement of the participant: I hope you will cooperate me to examine you thoroughly and will come to me for follow up.
9.
Risk and benefits: No reasonable risk with this study but benefits is to help a
research outcome that will help further more appropriate management with
Removable Partial Denture.
10.
Privacy, anonymity, confidentiality: Your Information will be kept secret. You
have given the permission to publish photographs for publication in any form
if needed for the public interest.
11.
Right to withdraw: You are free to take part or withdraw yourself from the
study at any time for any reason. If you are agreeing to our proposal of
enrolling you / your patient in our study, Please indicate that by putting your
Signature or left thumb impression at the specified below.
Thank you for your cooperation.
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--------------------------------------------
----------------------------------------
Signature or Left Thumb Impression of the
Signature or Left Thumb Impression
Attendant/Guardian
-------------------------------------Signature of the Investigator
of the Participant
--------------------------------------------------Signature or Left Thumb Impression of
a Witness
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সম্মতি পত্র
Title of the study:
Investigator`s name: Major Nadia Jahan.
এই ঴ম্মতি পত্রের উত্রেলয ঵঱ আপনাত্রে প্রত্রয়াজনীয় িথ্য প্রদান েরা, যয িথ্য গুত্র঱া আপনাত্রে ত঴দ্ধান্ত তনত্রি ঴া঵াযয েরত্রব, আপতন এই
গত্রব঳ণায় অংলগ্র঵ণ েরত্রবন তে না।
গবেষণার ঝুতি :
এই গত্রব঳ণায় অংলগ্র঵নেৃি যরাগীত্রদর তেছু পরীক্ষা েরা ঵ত্রব, এত্রি যোন ঝুুঁ তের ঴ম্ভাবনা নাই।
গবেষণার অংশগ্রহবের সু তেধাতি :
এই গত্রব঳ণায় অংলগ্র঵ন েরত্র঱ উক্ত যরাত্রগর ঴ঠিে তিতেৎ঴া পদ্ধতি ঴ম্পত্রেে বণেনা যদওয়া ঵ত্রব। ফত্র঱ তিতেৎ঴ায় মান বৃ তদ্ধ পাত্রব এবং পরবিীত্রি
উক্ত যরাত্রগ অ঴ু স্থিার ঵ার হ্রা঴ পাত্রব।
তেিল্প :
এই গত্রব঳ণায় অংলগ্র঵ন েরা তেংবা না েরার বযাপাত্রর অথ্বা অংলগ্র঵ন েরার পর যযত্রোন ঴ময় আপতন গত্রব঳ণা যথ্ত্রে ঴ত্রর যযত্রি পারত্রবন।
খরচ :
এই গত্রব঳ণায় অংলগ্র঵ত্রনর জনয আপনার যোন খরি যনই বা আপনাত্রে যোন অথ্ে যদয়া ঵ত্রব না।
গগাপেীয়িা :
গত্রব঳ণা ি঱াো঱ীন ও পরবিীত্রি ঴ে঱ িথ্য েত্র ারভাত্রব যগাপন রাখা ঵ত্রব । আপনার বাতক্তগি তব঳য়াতদ িথ্য তবত্রে঳ণ প্রতিত্রবদন তিতর ও
প্রোলনার োত্রজ বযাব঵ার েরা ঵ত্রব এবং গত্রব঳ণার পরীক্ষে বযিীি োত্ররা োত্রছ প্রোল েরা ঵ত্রবনা ।ফলে আপনার যোন িথ্য যেউ জানত্রি
পারত্রব না ।
গেচ্ছামূ লি অংশগ্রহে :
এই গত্রব঳ণায় আপনার অংলগ্র঵ন ঴ম্পূ ণে যেচ্ছামূ ঱ে । আপতন গত্রব঳ণায় অংলগ্র঵ত্রন অেীেৃতি জানাত্রি পাত্ররন অথ্বা গত্রব঳ণা ি঱াো঱ীন যয
যোন ঴ময় গত্রব঳ণা যথ্ত্রে আপনার নাম প্রিযা঵ার েত্রর তনত্রি পাত্ররন । িাত্রি আপনার তিতেৎ঴ার যোন িারিময ঵ত্রব না । এই ফরত্রম োক্ষর
েরত্র঱ আপনার আইনগি যোন অতিোর খবে ঵ত্রব না ।
প্রশ্নােলী:
যতদ আপনার যোন প্রশ্ন থ্াত্রে িত্রব দয়া েত্রর তজজ্ঞা঴া েরুন, আতম িার উত্তর প্রদান েরার যথ্া঴ািয যিষ্টা েরত্রবা । যতদ ভতব঳যত্রি আপনার
অতিতরক্ত যোন প্রশ্ন থ্াত্রে িা঵ত্র঱ গত্রব঳ণারি ডাক্তাত্ররর ঴াত্রথ্ যযাগাত্রযাগ েরত্রি পাত্ররন ।
সম্মতি েীিাবরাতি :
আতম গত্রব঳ণায় তনত্রয়াতজি তিতেৎ঴ত্রের ঴াত্রথ্ এই গত্রব঳ণা তনত্রয় আত্র঱ািনায় ঴ত্রন্তা঳ প্রোল েরতছ । আতম এটা বু ত্রঝতছ যয, গত্রব঳ণায়
অংলগ্র঵ন ঴ম্পূ ণে যেচ্ছামূ ঱ে এবং আতম যয যোন ঴ময় যোন বািযবািেিা ছাড়াই গত্রব঳ণা যথ্ত্রে আমাত্রে তবরি রাখত্রি পাতর । আতম
উপত্ররাক্ত লিে গুত্র঱া পত্ররতছ / আমার ঴ম্মু ত্রখ পঠিি ঵ত্রয়ত্রছ এবং যেচ্ছায় গত্রব঳ণায় অংলগ্র঵ত্রন ঴ম্মতি জ্ঞাপন েরতছ ।
সাক্ষাৎিারগ্রহণিারীর োক্ষর
িাতরখ
অংশগ্রহণিারীর োক্ষর
িাতরখ
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অতিিােবির োক্ষর
িাতরখ
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Military Dental Centre Dhaka
Dhaka Cantt
APPLICATION FOR ETHICAL CLEARANCE OF RESEARCH PROPOSAL
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1. Investigator:
Major Nadia Jahan
Trainee
Grading in Prosthodontics
Department of Prosthodontics.
Military Dental Centre Dhaka. Dhaka Cantt
2. Guide:
Col Md Tariquzzaman,D-prostho,FCPS
Classified Specialist in Prosthodontics.
Military Dental Centre Dhaka. Dhaka Cantt.
3. Place of the study: Department of Prosthodontics, Military Dental Centre Dhaka. Dhaka
cantonment.
4. Title of the study:.A comparative study on tissue response under the ridge lap and
modified ridgelap pontics amongst the patient attending to the MDC Dhaka.
5. Duration:
1 year
6. Total cost:
NA
7. Funding Agency (IF Applicable): NA
We agree to obtain approval of the Institutional Ethical Committee of MDC Dhaka for any
changes involving the rights and welfare of subjects or any changes of the methodology before
making any such changes.
Abstract for Ethical Committee
Title: A Comparative Study On Tissue Response Under The Ridge Lap And Modified
Ridgelap Pontics.
Background:. The pontic or an artificial tooth is the main component of a fixed
partial denture. The pontic is defined as “the artificial tooth suspended from the abutment
teeth. According to the glossary of prosthodontic terms a pontic is defined as “an artificial
tooth on a fixed partial denture that replaces a missing natural tooth restores its functions,
and usually fills the space previously occupied by the clinical crown.In this role, the pontic
should restore function, provide esthetics and comfort, be biologically acceptable, permit
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effective oral hygiene, and preserve underlying residual mucosa.There are various types of
pontics used in fixed prosthodontics. According to shape the pontic can be divided into
ridge lap, modified ridge lap, sanitary, modified sanitary, saddle, modified saddle,
conical, bullet and heart shaped pontic. According to material a pontic may be classified
in all metal, metal and porcelain, combination of metal and resin.The aim of this study is to
observe tissue response under the ridge lap and modified ridgelap pontic and condition of
interdental papilla under the connector of fixed partial denture and to evaluate periodontal
status of the abutment teeth.
Objectives: The study was designed to observe the tissue response under the ridge lap and
modified ridgelap pontic
Place of study: Department of Prosthodontics in Military Dental Centre Dhaka.
Period of study: From 1 February 2021 to 31 January 2022
Sample selection: Patients come seeking treatment for their missing mandibular first molar
teeth in the department of Prosthodontics, Military dental centre Dhaka will be taken.
Results: 40 diagnosed mandibular 1st molar missing patients were included in this study. All
these patients were evaluated under 2 parameters and those evaluation were described in
tables. The parameters are the condition of mucous membrane and the condition of abutment
tooth.In case of group A, 3 patients were found in grade I, 6 in grade II, 4 in grade III and 7 in
grade IV whereas in group B 9 patients were in grade I, 7 were in grade II, 2 in grade III and
2 patients were found in grade IV, after 6 weeks. The chi-square test was done as the test of
significance and the P value was >0.05 which was statistically not significant. After 12 weeks
interpretation 3 patients were found in grade I, 5 in grade II, 7 in grade III and 5 were found
in grade IV respectively in case of group A, whereas 10 patients were found in grade I, 4
were grade II, 4 were grade III and 2 patients were found in grade IV in case of group B. The
chi-square test was done as the test of significance and the P value was <0.05 which was
statistically significant. After 6 months interpretation in group A 2 patients were found in
grade I, 5 were in grade II, 5 were in grade III and 8 were in grade IV respectively, whereas
in group B grade I had 9 patients, grade II had 4 patients and there were 5 patients in grade III
and 2 patients were grade IV respectively. The chi-square test was done as the test of
significance and the p value was <0.05 which was statistically significant..
Research Ethics Initial Checklist
Please Tick (√) the appropriate answer in relation to your proposed research
1
2
3
4
Are human participants required in this research?
Will the research involve participants vulnerable or unable to give informed consent
(e.g., children, inmates, adults with learning difficulties, physical or mental
impairments)?
Could any aspect of the research cause any harm, physical or psychosocial stress to
participants or third parties beyond expectation in everyday life, or pose potential
risks to the researcher(s)?
Will the research collect confidential, protected or otherwise politically or culturally
sensitive data (e.g., sexual behavior or preference, experience of violence or abuse,
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Yes
No
√
√
√
√
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5
6
7
8
9
10
11
12
13
14
mental health, ethnic status, religious belief)?
Will the research involve collection of medical or biological data?
Does the study involve invasive or intrusive procedures?
Will material or financial inducements (other than reasonable expenses and
compensation for time) be offered to participants?
Could the research entail or lead to conflicts of interest (e.g., financial sources
compromising the independence or objectivity of the research)?
Could the image of this Institute, academic departments, research Centreor any other
institute involved be negatively affected by this research?
Could any aspect of the research produce information that could lead to criminal
prosecution of the participants or others?
Will you inform participants that their participation is voluntary and their right to
refuse to participate or to withdraw from the study?
Will signed consent/verbal consent be required from study subjects?
Will the subjects be informed about nature and purpose of the study, procedures
including alternatives, physical risks, benefits from the study?
Will precautions be taken to protect anonymity of the subjects?
√
√
√
√
√
√
√
√
√
√
Declaration by the Applicant
I hereby certify that the above-mentioned statements are true, I have read and understood the regulation of the
Ethical Committee on the approval of research proposal and will act in conformity with the regulation. I declare
that the details above reflect accurately my research proposal. I understand that if granted, this approval will
apply to the current research protocol and timeframe.
………………………………….
Signature of Applicant
Date: ………………
Declaration by the Supervisor (if applicable)
I have read this application. I am satisfied that it is in line with the criteria set out by the Institutional Ethical
Committee.
……………………………………..
Supervisor’s Signature
Date: …………………
Date:
To
The Supervisor,
Department of Prosthodontics.
Military Dental Centre Dhaka, Dhaka Cantonment.
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Subject:Application for the approval of the dissertation protocol for Grading in
Prosthodontics
Sir,
With due respect, I humbly state that I am Major Nadia Jahan a trainee in grading at the
department of Prosthodontics. As a requirement of grading examination, dissertation work
has to be undertaken. After reviewing available literatures and consultation with the
honorable teachers, I have decided to do my dissertation work on a comparative study on
tissue response under the ridge lap and modified ridgelap pontics.I therefore, hope that you
would be kind enough to approve my dissertation protocol enclosed herewith and supervise
me in my dissertation work.
Yours Obediently,
………………………………………
Major Nadia Jahan
Trainee
Grading in Prosthodontics
Department of Prosthodontics
Military Dental Centre Dhaka,Dhaka Cantonment.
Date:
To
The President,
Ethical Committee
Military Dental Centre Dhaka, Dhaka Cantonment
Through Supervisor, Department of Prosthodontics.
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Subject: Application for ethical clearance of the dissertation protocol titled a
comparative study on tissue response under the ridge lap and modified ridgelap pontics
Sir,
With due respect and humble submission, I would like to state that I am a grading trainee
(Prosthodontics,MDC, Dhaka). As part of the training, I would like to perform my
dissertation on a comparative study on tissue response under the ridge lap and modified
ridgelap pontics under supervision of Col Md Tariquzzaman,FCPS.
Therefore, I hope that you would kindly approve my dissertation by giving me the ethical
clearance to go ahead with my study. I shall be grateful and obliged thereby.
Yours Obediently,
………………………………………
Major Nadia Jahan
Trainee
Grading in prosthodontics
Department of Prosthodontics.
Military Dental Centre Dhaka, Dhaka Cantonment.
Enclosures:
a) Dissertation protocol
b) Data collection sheet
c) Consent form
Board of Approval
Military Dental Centre Dhaka
We the members of Institutional Ethical Committee certify that we have carefully read and
recommended to the Department of Prosthodontics, MDC, Dhaka for approval of this proposal of
Dissertation entitled
A comparative study on tissue response under the ridge lap and modified ridgelap
pontics
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Submitted by Major Nadia Jahan partial fulfillment of the requirements for the Grading in
Prosthodontics
President:
BRIG GEN MD ABDUR RAB, FCPS
Commandant
……………………………
(Signature)
Members:
1. Head. Dept. of Conservative Dentistry &Endodontics.
2. Head Dept. of Oral & Maxillofacial Surgery.
……………………………
(Signature)
…………………………..
(Signature)
3. Head Dept. of Orthodontics & Dentofacial Orthopedics.
…………………………..
(Signature)
4. Head Dept. of Prosthodontics
……………………………
(Signature)
5. Religious Teacher of unit
…………………………..
(Signature)
Military Dental Centre Dhaka.
Dhaka Cantt
To
Major Nadia Jahan
Trainee
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Grading in prosthodontics
Department of Prosthodontics.
Military Dental Centre Dhaka, Dhaka Cantonment.
Your research protocol titled “a comparative study on tissue response under the ridge lap and
modified ridgelap pontics” as been approved by the ethical committee of Military Dental
Centre Dhaka, Dhaka cantonment for further procedure.
Thanking you.
………………………………..
Col Md Tariquzzaman,D-prostho,FCPS
Classified Specialist in Prosthodontics.
Military Dental Centre Dhaka. Dhaka Cantt.
Procedure for Maintaining Confidentiality
 All information regarding participants will be treated with the utmost confidentiality,
and will not be disclosed to anyone else without prior consent of, and that their
anonymity will be respected at all times unless otherwise determined by law.
 Proper safety method will be followed during oral examination and interview privacy
will be maintained.
 An ID number will be given to each of the patient which will be used during followup visits.
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 Research data will be coded. All data will be coded using a system known only to the
researcher to preserve the identity of the participant and will nevertheless allow the
participant access to her/his data at any time during the research process should this
be requested.
 Use of random identity numbers on participants’ data with a separate name/number
list.
 Data will be stored in a locked cabinet.
 Only research personnel will be allowed to access the data.
 Agreement to release of personal information should be sought only when the
participant is properly informed about possible harms that may occur.
 Confidential information provided by research participants, employees, clients or
others must be treated as confidential even if there is no legal protection or privilege.
 The obligation to maintain confidentiality extends to members of the research or
training teams and collaborating organizations who have access to the information.
 To ensure that access to confidential information is restricted, the principal researcher
is responsible for ensuring that researchers, administrators and other relevant parties
adequately trained and instructed to take the steps necessary to protect confidentiality.
CHECKLIST OF DOCUMENTS FOR ETHICAL COMMITTEE
Name of Applicant: Major Nadia Jahan
Title of Study A comparative study on tissue response under the ridge lap and modified
ridgelap pontics:
Documents
Enclosed
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Yes
 Application for Ethical Clearance
√
 Abstract for Ethical Committee
√
 Project Proposal/ Dissertation Protocol
√
 Participant Information Sheet
√
 Participant Consent Form
√
 Patient’s data collection sheet
√

Procedure for maintaining confidentiality
√

Application to the President of Ethical Committee,
MDC Dhaka for ethical clearance
√

Application to the Supervisor
√
Figures
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Figures-III: Dental spoon excavator
Figures-IV: Dental mirror
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Figures-V: Dental periodontal probe
Figures-VI: Dental caries probe
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