E D Schweikert | PubMed Health

PubMed1999

The multiple cantilever system: a solution for a failed precision attachment denture case.

Multiple-cantilevered pontic bridges can be a great alternative to dental implants and distal extension prostheses. Dental hygiene must be considered the most important factor in preserving the status quo of the permanent restoration. Traumatic occlusion, which can occur because of the widened periodontal space and greater mobility of a multiple-cantilever bridge, is not automatically a sign of failure. As long as the mobility of the fixed bridge does not increase and the patient can function and feel comfortable with it, a successful therapy can be concluded. If marginal periodontitis exists, destruction of the cervical ligaments, bone resorption, and apical migration of the epithelium will occur. Through loss of the supportive structures, hypermobility will increase. If the destructive factors of marginal periodontitis are not eliminated, the hypermobility can interfere with masticatory function. It is important that patients be made aware of this possibility. Regular recalls in the beginning of the maintenance program will emphasize the importance of the home-care system.

Bicuspid↗

PubMed1994

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.

Biomechanical Phenomena↗