What do you normally recommend to patients when restoring adjacent implants? Based on your experience, what is patient preference? What do you see as the advantages of splinting vs. restoring as single units?
Within the limitations of this systematic review and meta-analysis, it was concluded that there was no difference in the marginal bone loss and prosthetic complications of splinted and nonsplinted implant restorations; this is especially true for restorations in the posterior region. However, splinted restorations were associated with decreased implant failure. (J Prosthet Dent 2019;121:41-51)
The literature suggests that an external connection implant has more micromotion of the abutment during loading than an internal connection implant40,41; thus, splinting restorations retained by external connection implants may improve the stability of the system, decreasing the risk of implant failure. The increased stability of the internal connection implant is associated with the ability to reduce the stress transferred to the crestal bone.40,41 Therefore, its use with nonsplinted crowns might reduce the risk of implant failure. However, further clinical studies are required to clarify this issue.
de Souza Batista VE, Verri FR, Lemos CAA, Cruz RS, Oliveira HFF, Gomes JML, Pellizzer EP. Should the restoration of adjacent implants be splinted or nonsplinted? A systematic review and meta-analysis. J Prosthet Dent. 2019 Jan;121(1):41-51. doi: 10.1016/j.prosdent.2018.03.004. Epub 2018 Jun 29. PMID: 29961632.
Splint the restorations on adjacent implants. It will be more difficult to establish and maintain a properly tight interproximal contact between the implant restorations if they are separate. This is because of the lack of resiliency that would
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I definitely cannot improve on what the first responder wrote…and thank you for this.
I would add that each case is different with the main individual variables being the
occlusion both full mouth and on the side of the implants. In addition I would add
that the size of the implants needs to be considered. Overall non splinting is a more
patient friendly option as far as maintenance is concerned.