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 a specialist in dental public health, Director of the Centre for Evidence-Based Dentistry and Specialist Advisor to the Scottish Dental Clinical Effectiveness Programme (SDCEP) Development Team. A former editor of the Evidence-Based Dentistry Journal and chief blogger for the Dental Elf website until December 2023. Derek has been involved with a wide range of evidence-based initiatives both nationally and internationally since 1994. Derek retired from the NHS in 2019 remaining as a part-time senior lecturer at Dundee Dental School until the end of 2023.

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