Multiple cantilevers: an alternative to dental implants.
A solution to the problem of missing posterior teeth is presented. The prerequisite for solving this problem is that the remaining teeth must be positioned in one form or another in a triangle, as one can see in Figs. 2, 3 and 4. The tripod effect, in connection with the controlling effect of the mechano-receptors in the periodontal ligaments of the remaining abutment teeth, permit us to construct a functional fixed prosthesis. The feather-edged or knife-edged preparation technique creates long axial walls. Together with the parallel prepared abutment teeth, this must be viewed as the main-retentive feature for fixed prostheses with multiple cantilevers. In extreme situations, where one is uncertain about the outcome of a case, provisional laboratory fabricated restorations are excellent for evaluating the stability of the cross-arch splinted teeth. The whole bridge occasionally shows some mobility. As long as the mobility shows no increase over a period of time, and does not interfere with the patient's chewing ability, a permanent bridge with multiple cantilevers can be inserted. I usually include no more than three cantilevered pontics on each side of the arch in a multiple cantilevered bridge. A second molar is not replaced by a third cantilevered pontic. Its position in the arch may cause an overly strong lever action on the fixed prosthesis.
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D001696:Biomechanical Phenomena; D001732:Bite Force; D000044:Dental Abutments; D003758:Dental Implantation, Endosseous / Q000009:adverse effects; D015921:Dental Implants; D017268:Dental Prosthesis Retention; D003779:Denture Design / Q000379:methods*; D003830:Denture, Partial, Fixed; D005260:Female; D006801:Humans; D008409:Mastication; D008875:Middle Aged; D014086:Tooth Mobility / Q000517:prevention & control
D015921:Dental Implants