Clinical and radiographic evaluations of implant-supported cantilever fixed partial dentures replacing maxillary anterior teeth: A randomized clinical trial

Statement of problem: Replacing maxillary or mandibular anterior teeth with implant-supported prostheses is challenging because of the small mesiodistal and buccolingual dimensions, which can affect the number and position of implants and thus the definitive prosthetic design. Purpose: The purpose of this randomized clinical trial was to assess the clinical and radiographic outcomes of patients treated with implant-supported cantilever fixed partial dentures (ICFPDs) compared with implant-supported conventional fixed partial dentures to replace maxillary anterior teeth. Material and methods: Fourteen participants missing 2 central incisors and 1 lateral incisor (6 men and 8 women) with a mean age of 40 years (range, 30 to 50 years) were divided equally into 2 groups, the IFF group (n=7; implant-supported FPD design) and the ICF group (n=7; ICFPD). Each participant received 2 implants (13×3.75) according to the fixed partial denture design. All participants were evaluated in terms of the implant stability, peri-implant sulcus depth, marginal bone loss, gingival index, and plaque index at the baseline and after 6, 12, 18, and 24 months. Results: The clinical results revealed no significant difference between the 2 groups in the implant stability, gingival index, or plaque index over the follow-up period. However, regarding the average peri-implant sulcus depth, the implant adjacent to the cantilever showed a significant difference compared with the other implants after 24 months, with an average peri-implant sulcus depth of 2 mm, which was still within the typical range. The average marginal bone loss for implants near the cantilever was significantly higher than that for the other implants in the 2 designs, with a value of 1.8 mm at the 2-year follow-up examination, which was also within the typical range of bone loss per year. Conclusions: Under the conditions of this randomized clinical trial, implant-supported cantilever fixed dental prostheses can be used successfully to replace maxillary anterior teeth.