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(Reference retrieved automatically from Web of Science through information on FAPESP grant and its corresponding number as mentioned in the publication by the authors.)

Should the restoration of adjacent implants be splinted or nonsplinted? A systematic review and meta-analysis

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de Souza Batista, Victor E. [1] ; Verri, Fellippo R. [2] ; Lemos, Cleidiel A. A. [2] ; Cruz, Ronaldo S. [2] ; Oliveira, Hiskell F. F. [2] ; Gomes, Jessica M. L. [2] ; Pellizzer, Eduardo P. [2]
Total Authors: 7
[1] Univ Western Sao Paulo UNOESTE, Presidente Prudente Dent Sch, Dept Prosthodont, Presidente Prudente - Brazil
[2] Sao Paulo State Univ UNESP, Aracatuba Dent Sch, Dept Dent Mat & Prosthodont, Aracatuba - Brazil
Total Affiliations: 2
Document type: Review article
Source: JOURNAL OF PROSTHETIC DENTISTRY; v. 121, n. 1, p. 41-51, JAN 2019.
Web of Science Citations: 2

Statement of problem. The decision to splint or to restore independently generally occurs during the planning stage, when the advantages and disadvantages of each clinical situation are considered based on the proposed treatment. However, clinical evidence to help clinicians make this decision is lacking. Purpose. The purpose of this systematic review and meta-analysis was to assess the marginal bone loss, implant survival rate, and prosthetic complications of splinted and nonsplinted implant restorations. Material and methods. This study was designed according to the Cochrane criteria for elaborating a systematic review and meta-analysis and adopted the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement. Also, this review was registered at the International Prospective Register of Systematic Reviews (PROSPERO) (CRD42017080162). An electronic search in the PubMed/MEDLINE, Cochrane Library, and Scopus databases was conducted up to November 2017. A specific clinical question was structured according to the population, intervention, comparison, outcome (PICO) approach. The addressed focused question was ``Should the restoration of adjacent implants be splinted or nonsplinted?{''} The meta-analysis was based on the Mantel-Haenszel and inverse variance methods to assess the marginal bone loss, implant survival, and prosthetic complications of splinted and nonsplinted implant restorations. Results. Nineteen studies were selected for qualitative and quantitative analyses. A total of 4215 implants were placed in 2185 patients (splinted, 2768; nonsplinted, 1447); the mean follow-up was 87.8 months (range=12-264 months). Quantitative analysis found no significant differences between splinted and nonsplinted restorations for marginal bone loss. The assessed studies reported that 75 implants failed (3.4%), of which 24 were splinted (99.1% of survival rate) and 51 were nonsplinted (96.5% of survival rate). Quantitative analysis of all studies showed statistically significant higher survival rates for splinted restorations than for nonsplinted restorations. Ceramic chipping, screw loosening, abutment screw breakage, and soft tissue inflammation were reported in the selected studies. The quantitative analysis found no statistically significant difference in the prosthetic complications of splinted and nonsplinted restorations. Conclusions. 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. (AU)

FAPESP's process: 15/07383-8 - Biomechanical analysis of prosthetic options for rehabilitation of posterior maxillary area with three-unit fixed prosthesis supported by implants
Grantee:Victor Eduardo de Souza Batista
Support Opportunities: Scholarships in Brazil - Doctorate