Distal Cantilever in Full-Arch Prostheses and Immediate Loading: A Retrospective Clinical Study

Purpose: The purpose of this study was to analyze and evaluate the clinical success of distal cantilevers of fixed full-arch prostheses for the rehabilitation of edentulous arches in conjunction with immediate loading. Materials and Methods: Twenty-seven patients (15 men and 12 women) with a mean age of 59 years received 203 implants (Ankylos, Dentsply), either in edentulous jaws or after extraction and immediate implant placement. All implants were splinted together with provisional restorations and loaded immediately after surgery. After an average of 60 days, the definitive prostheses were fabricated and cemented provisionally. Thirty-one prostheses were delivered. A total of 92 units on distal cantilevers were incorporated into the prostheses. Implant stability was recorded (via percussion testing) after prostheses were removed and crestal bone levels were measured with radiographs. Results: Average crestal bone loss was 0.33 mm. After a follow-up of 5 years, only one prosthesis broke (at the connection between the main part of the denture and the distal extension). A total of five implants were lost because of overloading or peri-implantitis (during early healing). The success rate of implants was 94.5%, the survival rate was 97.5%, and the survival rate of the prostheses was 96.7% after a loading period of 79.30 ± 35.31 months. Conclusions: Based on the long-term clinical data, distal cantilevers on a full-arch prosthesis can be a successful treatment modality and can be employed in patient treatment planning when posterior support is indicated. Keywords: cantilever, complications, crestal bone loss, implant-retained prostheses