Decision-making for treatment planning a cantilevered fixed partial denture

Considerable controversy exists in the dental literature regarding cantilevered pontics. This article discusses basic concepts of the cantilever fixed partial denture (CFPD) in which one cantilevered pontic is supported by only one or two abutment teeth. Three primary factors should be considered carefully to optimize the prognosis for a CFPD: abutment selection, control of functional forces, and rigidity/strength of connectors. Abutments should have a root surface area greater than the tooth being replaced and a crown-to-root ratio of 2:3. They also should exhibit minimal mobility and be vital and periodontally sound. Contact on cantilevered pontics should be light in centric position and nonexistent in excursions. CFPDs ideally should be metal or metal-ceramic, and connectors, which are high-stress areas, require bulk for strength. A cantilevered prosthesis may require more consideration and planning than a conventional fixed partial denture, but when kept within the patient's biological limitations and executed properly, can provide a restorative option with many advantages.