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A single-tooth implant restoration is generally performed for maxillary single-first-molar replacement. If the interdental space between the second premolar and the second molar is large enough, a double-implant placement can be performed to avoid creating mesiodistal cantilever and to distribute occlusal loading forces.  If there is not adequate space for a double-implant placement to be performed mesiodistally along the crest of the alveolar ridge line, they should be placed along a diagonal line offset lingually to increase the space. This procedure has two primary advantages. First, greater stability is provided by a double-implant placement. Resistance to lateral forces (palatal-buccal) is much stronger than two implants placed along the alveolar crest ridge line. Residual palatal and buccal bone can provide support against occlusal forces, provided that there is adequate residual bone in these regions.  If anatomical conditions are favorable, the placement of two diagonal implants in the palatal and buccal residual bones can be a rational procedure.  We report on two typical patients. The progress of these patients was followed using computed tomography for 7 and 6 years, respectively.

international journal of implant dentistry

Case presentation of two patients using diagonal platform-switched double implants for maxillary single-first-molar replacement as the alternative of a single-tooth implant