Himmel R, Pilo R, Assif D, Aviv I
Department of Oral Rehabilitation, Tel Aviv University, Maurice and Gabriela Goldschleger School of Dental Medicine, Israel.
J Prosthet Dent. 1992 Apr;67(4):484-7. doi: 10.1016/0022-3913(92)90077-n.
The cantilever fixed partial denture (FPD) is a restoration with one or more abutments at one end and unsupported at the other end. Forces transmitted through the cantilevered pontics can cause tilting and rotational movements of the abutments. In a cross-arch unilateral cantilever FPD, the distal cantilevered unit is subjected to comparatively less force than the contralateral posterior abutment. The unilateral lack of terminal abutments causes lateral bending forces activate peripheral inhibitory feedback reactions from the periodontal and/or temporomandibular mechanoreceptors. The greatest strain in distal cantilevered FPDs is recorded mesial to the most distal retainer because most fractures occur in this location. To improve the prognosis of the FPD cantilever, the number of abutments should be increased and the number of pontics decreased. The abutment teeth need long roots and acceptable alveolar support. Prepared abutments require adequate length and parallel axial walls. An equilibrated and harmonious occlusion is necessary, as well as exemplary oral hygiene. A cantilevered FPD with adequate periodontal support can replace any tooth in the dental arch, but is especially useful as an alternative to a removable partial denture. The cantilevered FPD requires at least two abutment teeth. The only documented exception permitting a single abutment is the replacement of a maxillary lateral incisor with the canine as an abutment. An alternative to the cantilevered FPD is the osseointegrated implant. As osseointegrated implants become more popular, the need for the tooth-supported cantilevered FPD may decline, but it will remain an alternative treatment modality.
悬臂式固定局部义齿（FPD）是一种一端有一个或多个基牙而另一端无支撑的修复体。通过悬臂式桥体传递的力可导致基牙倾斜和旋转运动。在跨牙弓单侧悬臂FPD中，远中悬臂单元所承受的力比同侧后牙基牙相对较小。单侧缺乏末端基牙会导致侧向弯曲力激活来自牙周和/或颞下颌机械感受器的外周抑制性反馈反应。远中悬臂FPD中最大应变记录在最远端固位体的近中，因为大多数骨折发生在这个位置。为了改善FPD悬臂的预后，应增加基牙数量并减少桥体数量。基牙需要有长牙根和可接受的牙槽骨支持。预备后的基牙需要有足够的长度和平行的轴向壁。平衡和谐的咬合以及良好的口腔卫生是必要的。具有足够牙周支持的悬臂式FPD可以替代牙弓中的任何牙齿，但作为可摘局部义齿的替代方案尤其有用。悬臂式FPD至少需要两个基牙。唯一有记录的允许单个基牙的例外情况是用上颌尖牙作为基牙替代上颌侧切牙。悬臂式FPD的替代方案是骨结合种植体。随着骨结合种植体越来越受欢迎，对牙支持式悬臂FPD的需求可能会下降，但它仍将是一种替代治疗方式。
