Purpose: The ultimate goal in modern esthetic dentistry is the restoration of lost hard and soft tissues by imitating nature as closely as possible. With the increasing esthetic awareness of patients, surgical and technical developments, and dentists' enhanced skills and knowledge, optimal function and esthetics are achievable even with implant-supported restorations in molar regions. Anatomic and morphologic factors and poor bone quantity and quality might reduce success rates of dental implants in the posterior jaw. Today, there are two options to replace a single missing molar by an implant-supported crown: the single wide-diameter implant or two standard-diameter implants. These two approaches are described and their advantages and disadvantages discussed in two exemplary clinical cases.
Materials and methods: In one case, the edentulous ridge in the area of the mandibular right first molar (FDI tooth 46) provided sufficient mesiodistal space to restore tooth 46 with a porcelain-fused-to-metal crown on two standard-diameter implants, placed in a root-analog manner. In the other case, the manibular first molars (FDI teeth 36 and 46) were replaced by porcelain-fused-to-metal crowns on wide-diameter implants.
Results: It can be concluded that both options to replace a single molar provide more surface area and better biomechanical properties than one standard implant.
Conclusion: Long-term data are needed before these treatment modalities can be recommended for the private practitioner.