title: How to treat two adjacent missing teeth with dental implants. A systematic review on single implant-supported two-unit cantilever FDP's and results of a 5-year prospective comparative study in the aesthetic zone.
abstract: To conduct a systematic review on the clinical outcome of single implant-supported two-unit cantilever FDP's and to conduct a 5-year prospective comparative pilot study of patients with a missing central and lateral upper incisor treated with either a single implant-supported two-unit cantilever FDP or two implants with solitary implant crowns in the aesthetic zone. Medline, Embase and the Cochrane Central Register of Controlled Trials were searched (last search 1 August 2016) for eligible studies. In the comparative pilot study, an implant-cantilever group of five patients with a single implant-supported two-unit cantilever FDP (NobelReplace Groovy Regular Platform) was compared with an implant-implant group of five patients with two adjacent single implant-supported crowns (NobelReplace Groovy Regular Platform) in the aesthetic zone. Implant survival, marginal bone level (MBL) changes, pocket probing depth, papilla index and patient satisfaction were assessed during a 5-year follow-up period. Five of 276 articles were considered eligible for data extraction. Implant survival ranged from 96·6% to 100%. Marginal bone level changes were higher in the anterior region than in the posterior region. Technical complications occurred more often in the posterior than anterior region. In the 5-year comparative pilot study, no clinically significant differences in hard and soft peri-implant tissue levels occurred between both groups. Single implant-supported two-unit cantilever FDP's can be a viable alternative to the placement of two adjacent single implant crowns in the aesthetic zone. Due to technical complications, placement of two-unit cantilever crowns in the posterior region can be considered unwise.
authors.affiliation: Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, Groningen, The Netherlands.
authors.forename: W G
authors.identifier: http://orcid.org/0000-0002-3687-0572
authors.initials: WG
authors.lastname: Van Nimwegen
authors.affiliation: Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, Groningen, The Netherlands.
authors.forename: G M
authors.initials: GM
authors.lastname: Raghoebar
authors.affiliation: Private Dental Practice, Ureterp, The Netherlands.
authors.forename: N
authors.initials: N
authors.lastname: Tymstra
authors.affiliation: Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, Groningen, The Netherlands.
authors.forename: A
authors.initials: A
authors.lastname: Vissink
authors.affiliation: Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, Groningen, The Netherlands.|Department of Fixed and Removable Prosthodontics, Centrum voor Tandheelkunde en Mondzorgkunde, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
authors.forename: H J A
authors.initials: HJA
authors.lastname: Meijer
mesh_terms: D019250:Dental Implants, Single-Tooth; D017267:Dental Prosthesis Design; D019094:Dental Prosthesis, Implant-Supported; D004955:Esthetics, Dental; D017408:Guidelines as Topic; D006801:Humans; D007576:Jaw, Edentulous, Partially / Q000601:surgery*; D010865:Pilot Projects; D011446:Prospective Studies; D016896:Treatment Outcome
keywords: adjacent implants; aesthetic zone; cantilever; dental implants; systematic review