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Background Dental implant technology has developed rapidly in recent years.However,the use of implant-supported fixed bridges with cantilevers has been controversial.The purpose of this study was to evaluate the clinical results of the mandibular anterior implant-supported fixed bridges with a cantilever.Method Thirty-three patients (15 males,18 females; mean age,42.6 years; range 20-54 years) with two missing anterior mandibular teeth had single implant-supported fixed bridges with a cantilever.Clinical examination was recorded and radiographs were taken.The mean duration of follow-up was 30 months (15-44 months).Results All implants survived.Loosening or fracture of the prosthesis was not observed.All patients were satisfied with the treatment.The mean bone resorption values after 12,24,and 36 months of implant loading were 0.94,1.18 and 1.35 mm respectively.The changes of gingival papilla height ranged from 0 to 0.5 mm.There was significant difference between 1-year and 2 or 3 years restoration groups regarding the average gingival height changes (P ＜0.05).Conclusion After careful and precise selection of patients,restoration with a single implant-supported fixed bridge with a cantilever can be recommended if two anterior mandibular teeth are missing.