Implants: splint or not for implant-supported overdentures?

shutterstock_70163050 dental implants

The purpose of this review was to examine difference between splinted and unsplinted implants for implant-supported overdentures regarding (i) survival rates, (ii) prosthetic ⁄ technical complications, (iii) peri-implant parameters ⁄ biological complications and (iv) patient satisfaction.

The authors searched the Cochrane Central Register of Controlled Trials (CENTRAL) and MEDLINE (Pubmed) databases and hand searched a number of relevant journals (British Journal of Oral and Maxillofacial Surgery, Clinical Implant Dentistry and Related Research, Clinical Oral Implants Research, Deutsche Zahnärztliche Zeitschrift, International Journal of Oral and Maxillofacial Implants, International Journal of Periodontics and Restorative Dentistry, International Journal of Prosthodontics,Journal of Clinical Periodontology, Journal of Oral Implantology, Journal of Oral Rehabilitation, Journal of Prosthetic Dentistry, Quintessence International, Schweizerische Monatsschrift Zahnmedizin) together with the references of identified articles.

Randomized clinical trials (RCTs) and prospective or retrospective cohort studies in English or German with a follow-up of three years or more were included. Twelve studies met the criteria and a narrative synthesis presented.

They found that data for the upper jaw was limited but for the lower jaw they concluded  that:-

  • There is no difference in implant survival rates between splinted and unsplinted design
  • The unsplinted design needs more prosthetic maintenance and the bar-clip implant-supported overdenture has been shown to be a more successful prosthesis
  • Peri-implant outcome does not significantly differ between splinted and unsplinted implants retaining an implant-supported overdenture.
  • The attachment mechanism did not have a notable effect on general patient satisfaction, and only in the aspect of prosthesis retention, the satisfaction for the bar-clip group was significantly higher.

Stoumpis C, Kohal RJ.To splint or not to splint oral implants in the implant-supported overdenture therapy? A systematic literature review. J Oral Rehabil. 2011 Apr 11. doi: 10.1111/j.1365-2842.2011.02220.x. [Epub ahead of print] PubMed PMID: 21480943.

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Derek Richards

Derek Richards is the Director of the Centre for Evidence-based Dentistry, Editor of the Evidence-based Dentistry Journal, Consultant in Dental Public Health with Forth Valley Health Board and Honorary Senior Lecturer at Dundee & Glasgow Dental Schools. He helped to establish both the Centre for Evidence-based Dentistry and the Evidence-based Dentistry Journal. He has been involved with teaching EBD and a wide range of evidence-based initiatives both nationally and internationally since 1994.

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