Cantilever Bridges; an Implant Alterntive

What Is a Cantilever Bridge?

Imagine an architectural bridge extending from one side of a river over to the other, supported by bridge abutments on both ends. If you take away one of those abutments, you can now imagine a cantilever bridge. It’s more like a diving board — firmly attached on one side and yet still able to support the weight of a person (or in this case, a tooth) at its other end. Often two teeth or two implants are used to support the “floating” tooth for strength.

For you motor heads and racing fans, during the Singapore Grand Prix Formula One race just a few weeks ago, the drone shots kept showing an awesome building that has the longest cantilevered structure made by man. It’s a giant roof top with a park full of trees and greenery and an observation deck. The race was one by Carlos Sainz from Team Ferrari……..but I digress…….(If we start talking cars; we’ll be here all day!)

The cantilever bridge is used when there is only one adjacent supporting tooth. They are often used to replace a missing front tooth and when a missing tooth area has insufficient bone to successfully anchor the implant, or for patients on medications for osteoporosis such as Prolia injections. These medications can cause implants to fail.

Advantages of Cantilever Bridges

• Good appearance: When used in the “aesthetic zone,” or front of the mouth, the cantilever bridge can provide a functional and a much more attractive replacement tooth vs a dental implant. Often an implant used to replace upper front teeth will have an un-even gumline compared to the adjacent teeth or may show a gray metal line in your smile.
• More conservative: The nature of the cantilever bridge involves fewer teeth, which means that more natural tooth structure can remain. The treatment is also reversible.
• Fewer complications: Some may argue that the more conservative nature of this restoration allows for fewer opportunities for complications compared with other treatments, such as dental implants.
• A great choice for those missing upper back teeth and have sinuses that are in the way of placing dental implants.
• Lower cost: Because this technique is typically more conservative and usually involves fewer teeth, it may also turn out to be less expensive, compared with dental implants.
• There is a high survival rate of up to 81.8% after 18 years.

Disadvantages of Cantilever Bridges

• Risk of damage: The unique structure of a cantilever bridge, with one side unsupported, can lead to a higher chance of damage, cracking or debonding from the supporting tooth.
• Possibility of failure: Failures are more common when root canaled teeth are used as abutments.

To replace a missing tooth or teeth, the implant option is ideal in most cases, but there is certainly a place for the bridge.