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 (13x3.75) 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.