ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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Title Limited Evidence Supports Advantage of Splinting Short Dental Implants in Posterior Partially Edentulous Patients
Clinical Question Are splinted short posterior dental implants more successful than unsplinted?
Clinical Bottom Line Clinical evidence supports splinted dental implants have a better distribution of strain; but limited evidence supports an inconsequential advantage of splinting short implants in posterior partially edentulous patients.
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 24171498Mendonca/2013N=198, patients receiving splinted/nonsplinted implants.Retrospective case series
Key resultsPosterior partially edentulous patients were followed-up at 3-16 years after 219 splinted implant crowns in 86 patients and 234 nonsplinted implant crowns in 112 patients were placed. Five and 16 implants failed in the splinted and nonsplinted groups producing overall success rates of 97.7% and 93.2%, respectively. Success was determined by absence of mobility and pain symptoms, along with radiographic evaluation as bone loss less than 1mm during first year after placement and less than 0.2mm per year following years. Marginal bone levels were assessed radiographically just after loading through a mean 10 year follow-up. Despite no statistically significant difference between groups, failures were predominately within the first year and seen in men with <10mm implants supporting nonsplinted implant crowns (P=0.086).
#2) 22167421Yilmaz/2011 N=4, acrylic resin cast with 2 4x6 mm implants, splinted and nonsplinted prostheses.Laboratory study
Key resultsMaximum/tensile and minimum/compressive principal strains around implants with splinted and nonsplinted restorations were evaluated under vertical and oblique loading. Nonsplinted restorations under oblique loading demonstrated increased maximum principal strain (p=0.0051) and increased minimum principal strain as compared with a splinted restoration. Regardless, no statistical significance in strain difference may exist.
Evidence Search (splinted[All Fields] AND ("dental implants"[MeSH Terms] OR ("dental"[All Fields] AND "implants"[All Fields]) OR "dental implants"[All Fields]))
Comments on
The Evidence
As most of the available evidence was derived from a retrospective study, no conclusion can be made regarding splinted or unsplinted short posterior implants in male patients. Mendonca notes limitations of his study: lack of clinical data, limited radiographic assessment confined to mesial and distal bone levels, and the low number of failures to evaluate the risk factors.
Applicability The clinical advantage of splinting short dental implants in posterior partially edentulous patients has lack of evidence-based support. Other factors to consider: bone quality, patients health (diabetes, compromised immune system, etc.), occlusion, parafunctional activity, crown/implant ratio, nature of opposing occlusion (CD or dentate).
Specialty/Discipline (General Dentistry) (Prosthodontics) (Restorative Dentistry)
Keywords Splinted dental implants; Single dental implants; short dental implants
ID# 2603
Date of submission: 11/14/2013spacer
E-mail diana.cole@ucdenver.edu
Author Diana Cole
Co-author(s)
Co-author(s) e-mail
Faculty mentor/Co-author Brian Brada, DDS
Faculty mentor/Co-author e-mail brian.brada@ucdenver.edu
Basic Science Rationale
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