ICFDP – implant-supported cantilevered fixed dental prosthesis or much easier cantilever implant bridge

Cantilever implant bridge is a nice solution for someone missing 2 or more teeth adjacent to each other. It is the same idea as a cantilever bridge on natural teeth.

When is a good time to do a cantilever implant bridge?

Anatomical issues and economic constraints are the two biggest drivers of the use of a cantilever implant bridge. Maxillary sinus, inferior alverolar nerve, and the mental nerve are the main anatomical considerations when a cantilever is going to be useful. There are situations were a cantilever makes sense due to just a lack of bone in an area as well. Cantilevers are cheaper than doing another implant so that is the economic advantage. It is importnat to use an implant system with a thick diameter to avoid flowering.

Another good time for a cantilever implant bridge is a case of two missing teeth where you wish to maintain papilla. Testori Perio 2018

When is it not a good time to use a cantilever bridge?

Anyone with parafunctional habits is not a good candidate for anything with a cantilever. This statement is from Roccuzzo IJOI 2023 from references 31 and 32. Those individuals end up with higher mechanical and technical complications. Loss of retention of a cement retained crown can be an issue as seen by Schmid COIR 2020 where 35% of the patients had it occur and several having it occur multiple times.

Cantilever implant bridge research

Aglietta 2009 5-10 year meta-analysis

• 5‐ and 10‐year ICFDP cumulative survival rate of 94.3% and 88.9%

Keep the cantilever mesial distal width to premolar size 7-7.5mm Tarnow article in DT 2013

Little evidence of bone loss but increase in minor technical complications Torrecillas-Martínez IJOMI 2014. Therefore, if between a sinus lift and a 3 unit implant bridge or 2 implants and a cantilever, the cantilever is the way to go. Dereci JOI 2021

A nice discussion about cantilever implant bridges by Bill on DT.

Roccuzzo has the best review article on the topic.

Survival rates for a cantilever implant prosthesis        

Survival rates of TISP, cantilever implant bridge and a standard dental implant bridge are the same according to Rammelsberg JPD 2021.