Cantilever in Implant Dentistry :part2

About this episode

In part one of this file, we looked at the common biomechanical fear around cantilevers on implants, asking whether this lever arm leads to marginal bone loss and treatment failure over the long term. In this episode, which continues and closes out the same file, we get to the final outcome.

In this episode you'll hear what happens to survival and bone levels after an average of thirteen years in function, and if the cantilever itself isn't the culprit behind bone loss, what is. We'll also talk about the complication that actually drives cost over the long term — not the one everyone fears — and walk through a specific clinical frame that determines exactly which patient and which treatment plan these favorable results apply to. Stay with this episode for the final verdict on this file and an evidence-based clinical take.

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• Aglietta M, Iorio Siciliano V, Zwahlen M, Brägger U, Pjetursson BE, Lang NP, Salvi GE. A systematic review of the survival and complication rates of implant supported fixed dental prostheses with cantilever extensions after an observation period of at least 5 years. Clin Oral Implants Res. 2009;20:441-451. DOI
• Schmid E, Morandini M, Roccuzzo A, Ramseier CA, Sculean A, Salvi GE. Clinical and radiographic outcomes of implant-supported fixed dental prostheses with cantilever extension. A retrospective cohort study with a follow-up of at least 10 years. Clin Oral Implants Res. 2020. DOI
• Hälg GA, Schmid J, Hämmerle CHF. Bone level changes at implants supporting crowns or fixed partial dentures with or without cantilevers. Clin Oral Implants Res. 2008;19:983-990. DOI

The full text of all three papers is available in the DentCast Library.