Cantilever pontic with one implant, vs. two implants for #24/25?

Question

A national "implant center" chain suggested a cantilever pontic with an implant at #25, with the pontic supporting another crown for #24. A private dental practice suggested two separate implants. Are there any particular advantages / disadvantages to either, aside from cost?

Wendy S. Spektor, DDS · Answer

What a great question!  Having restored many Implants and understanding the many issues involved, there is no absolute answer to how many Implants should be placed when missing teeth. As you can see by the different answers already given for this question.The lower anterior teeth usually have very little space and placing one Implant and doing a Implant crown with a cantilever to replace the other missing tooth is very reasonable.  It is very difficult to restore 2 Implants side by side because of technical challenges (do you have enough bone and space)and esthetic difficulties(what will the crowns and gum look like?)You will need to trust the team that does the Implant and places the restorative.  Get another opinion and ask to see pictures!

Zev Kaufman, DDS · Answer

Dear GumBoy:The answer to your question is much more complicated.  There are distinct advantages to the restoration of the two lower incisors with a cantilever bridge.  As a matter of fact IT IS the preferred restoration for the situation in many cases.  The aesthetic result with a cantilever bridge off of an implant is many times SUPERIOR to having two adjacent implants.  There is a critical distance between two implants (generally three millimeters) which has to be observed.  In the lower anterior area (the front lower teeth) the bone is limited and the distance between the teeth is small.  If you do not have the room to have 2 mm between the adjacent teeth to the back and to allow about 3-4mm for implant size and 3mm between the implants, then placing two implants IS ABSOLUTELY NOT the right treatment.  You can have the implants placed, but you will never be able to have a nice pink tissue result with a natural undulating line and "scallop" of the tissue.If the space is limited, the BEST way to restore is with a single implant and a cantilever bridge.  If your teeth are really wide and there is space, you might want to get two implants, with the advantage of stability over time, since a long cantilever is not desirable. Here is what you should do...First, go to a Prosthodontist, who is the expert in this area.  There are plenty of general/cosmetic/family (all the same) dentists out there who can do the work, but if you have doubts, go to the authority on the matter and the person who actually has proper, formal education is the Prosthodontist.  Second, ask each dentist WHY they are prescribing their particular way of restoration.As I said, the determining factor is space.  That is what they should be able to explain to you.Best of luck,

Vicki Borowski, DDS · Answer

Placing 2 separate implants is a much more stable way to restore this area. A cantilever on one implant has a much greater risk of failure. The teeth in the front of your mouth are used for biting into things and tearing. there is a lot of stress placed on them. A cantilever is a false tooth which is unsupported attached to another tooth that is supported by the implant. The additional forces placed on the implant supported tooth by pressure on  the unsupported tooth can cause failure of the implant on several levels. I highly suggest using 2 implants if possible.

Cantilever pontic with one implant, vs. two implants for #24/25?

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Everything you need to know about Dental Implants

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Cantilever pontic with one implant, vs. two implants for #24/25?

Answers (3)

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Everything you need to know about Dental Implants

Our mission is to create a world where every investment in modern beauty is Worth It.