Guidelines for anterior cantilever distance?
I would like to treatment plan a patient for 2 splinted implants with an anterior cantilever. The implants are in 47, 46 sites. How do I determine how long I can make the anterior cantilever? What are the guidelines to determine this?
10 Comments on Guidelines for anterior cantilever distance?
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Dr. J-Bob
7/17/2017
Personally, I never go beyond a single pontic in either a mesial or distal extension.
Dan
7/17/2017
There are so many variable parameters in this game such as bone quantity and quality,implants and crowns dimentions ,type of occlusion ecc.to my opinion its impossible to have,up to date, an approved scientific answer to your question.whatever will be your choice,it's a bet and you'll need to be very very lucky.
Wish you all the best.
Montana
7/17/2017
Agreed, if only two implants, one tooth anteriorly. If three or more implants in an arc, possibly more if they are incisor pontics, but the opposing structure is a big factor.
Gregori Kurtzman, DDS, MA
7/17/2017
What teeth are missing being replaced with pontics? What opposes the implants and is this a male or female patient?
Aziz Amro
7/17/2017
Thank you for your questions
Female
Missing 45&44
Opposing are implant and natural tooth
Dennis Flanagan DDS MSc
7/17/2017
There has been some published work on this. To avoid prosthetic and support complications make the cantilever no more than 8mm.
Dan
7/18/2017
Dear colleague, I do not agree with this indication.
there is no scientific evidence based indication to this issue.
any number will be a belly decision.
in my opinion it is better to avoid the cantilever if possible
if not,do it as small as possible and.....hope for the best..
unfortunately we still have a lot of improvised clinical behavior
in our daily work,we are not yet in the definitive absolute science zone.
if you will ask 10 colleagues for their opinion, you'll get 20 answers
for every issue...
Best wishes..
Pedro
7/18/2017
Anterior cantilever guidance should be the same as posterior ( i.e. AP spread x 2). If possible oclusion should be given to the implant supported teeth and not on the Pontics. As every case it also depends on the type of oclusion, opposing arch, implant length, age and gender and the restorative materials you use.
Good luck.
Best
JP
Gregori Kurtzman, DDS, MA
7/18/2017
IMHO you should not cantilever two teeth mesial to the implants the span is too long. Best to place another implant at 44 then place a bridge.
dario
7/18/2017
why don't try with the anterior in a mesially tilted position ? If it would be possible to have the head of implant near the region of the second bicuspid (45), you might finalize with a conventional bridge ( 47-x-45 )
