Cantilever Bridge, also known as Cantilever Fixed Partial Denture, is a prosthesis where the pontic (artificial tooth) is supported on one side only by one or more abutment teeth. The pontic is attached to a single or to two retainers splinted together but has no connection at the other end of the artificial tooth. The abutment tooth or teeth may be either mesial or distal to the edentulous space.
Photo 1 about shows a Cantilever Fixed Partial Denture. It replaces the missing maxillary lateral incisor. The abutment used is a premolar. * Photo 1 can also be viewed at the Fixed Partial Dentures webpage.
Cantilever bridge is indicated where the abutment tooth or teeth can carry the occlusal load of the artificial tooth and where the occlusion is protected against potentially damaging rotational forces. It is the most conservative when one abutment is needed, like in restoration of a missing lateral incisor. If one tooth is used as abutment, there is no problem of paralelling abutment teeth during preparation. If two or more abutment teeth are used, they are adjacent to each other, it is easier to make tooth preparations parallel.
The length of span is limited to one pontic. It is important to place a contact point from the pontic to the neighboring tooth to minimize rotational forces. If two teeth are to be replaced, there have been some commonly practice methods to alleviate stress from mastication:
1. more teeth are added as abutments.
2. more rigid alloy is used in FPD fabrication.
3. the terminal abutment is prepared with a more apical margin.
Photo 2 about shows a Cantilever Fixed Partial Denture restoring the manbibular first molar. First and second premolars were used as abutments.
Based on a study conducted by Dr. C.H Wang, the Cantilever Fixed Partial Denture require at least two abutments. Optimum stress reduction occurred with a splinting of three abutments. To increase the number of abutment to more than three would not result in a proportional and meaningful reduction of stress in the periodontium.
C . H . Wang, H . E . L ee , C . C . Wang & H . P. Chang. Methods to improve a periodontally involved terminal abutment of a cantilever fixed partial denture – a finite element stress analysis, Journal of Oral Rehabilitation 1998 25; 253–257
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