REHABILITATION OF A SINGLE MOLAR USING TWO OSSEOINTEGRATED IMPLANTS: CLINICAL INDICATIONS, BIOMECHANICAL FUNDAMENTALS, AND PROSTHETIC BENEFITS

Abstract

Introduction: The rehabilitation of missing molars using osseointegrated implants presents biomechanical challenges related to high masticatory loads, the dimensions of the occlusal table, and the occurrence of eccentric forces. Although the use of a single implant is a well-established approach, placing two implants to support a single molar crown may be an alternative in select clinical situations. Objective: To analyze the clinical indications, biomechanical rationale, and potential prosthetic benefits of using two osseointegrated implants to replace a single molar, with an emphasis on the distribution of occlusal loads, the control of rotational movements, and the prevention of mechanical complications. Methods: A narrative review of the scientific literature was conducted, including clinical studies, systematic reviews, and publications concerning the biomechanics of implant-supported prostheses and mechanical complications involving prosthetic components. Results: Using two implants to support a single molar crown can provide an expanded support base and alter the distribution of occlusal loads. Potential benefits include the reduction of certain rotational moments, the distribution of mechanical stress across two supports, and the feasibility of rehabilitating molars with large coronal dimensions. However, this technique requires a careful assessment of bone volume, available prosthetic space, and oral hygiene conditions. There is insufficient evidence to claim that the use of two implants eliminates the loosening of prosthetic screws or abutments. Conclusion: Replacing a single molar with two implants may serve as a therapeutic alternative for carefully selected patients. Such an approach should take into account potential biomechanical benefits, anatomical limitations, surgical risks, and the need for long-term prosthetic maintenance.