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Should the restoration of adjacent implants be splinted or nonsplinted? A systematic review and meta-analysis
- Source :
- Scopus, Repositório Institucional da UNESP, Universidade Estadual Paulista (UNESP), instacron:UNESP
- Publication Year :
- 2019
- Publisher :
- Elsevier BV, 2019.
-
Abstract
- Made available in DSpace on 2018-12-11T17:21:16Z (GMT). No. of bitstreams: 0 Previous issue date: 2018-01-01 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. Associate Professor Department of Prosthodontics Presidente Prudente Dental School University of Western São Paulo (UNOESTE) Adjunct Professor Department of Dental Materials and Prosthodontics Araçatuba Dental School São Paulo State University (UNESP) Doctoral student Department of Dental Materials and Prosthodontics Araçatuba Dental School São Paulo State University (UNESP) Graduate student Department of Dental Materials and Prosthodontics Araçatuba Dental School São Paulo State University (UNESP) Full Professor Department of Dental Materials and Prosthodontics Araçatuba Dental School (UNESP) Universidade Estadual Paulista Adjunct Professor Department of Dental Materials and Prosthodontics Araçatuba Dental School São Paulo State University (UNESP) Doctoral student Department of Dental Materials and Prosthodontics Araçatuba Dental School São Paulo State University (UNESP) Graduate student Department of Dental Materials and Prosthodontics Araçatuba Dental School São Paulo State University (UNESP) Full Professor Department of Dental Materials and Prosthodontics Araçatuba Dental School (UNESP) Universidade Estadual Paulista
- Subjects :
- Databases, Factual
education
Population
Alveolar Bone Loss
Dentistry
Cochrane Library
Dental Prosthesis Retention
03 medical and health sciences
0302 clinical medicine
stomatognathic system
Humans
Medicine
Dental Restoration Failure
Survival rate
Dental Implants
education.field_of_study
business.industry
Dental Implantation, Endosseous
Dental prosthesis
Implant failure
030206 dentistry
humanities
Prosthesis Failure
stomatognathic diseases
Systematic review
Dental Prosthesis Design
Splints
Meta-analysis
Dental Prosthesis, Implant-Supported
Implant
Oral Surgery
business
Subjects
Details
- ISSN :
- 00223913
- Volume :
- 121
- Database :
- OpenAIRE
- Journal :
- The Journal of Prosthetic Dentistry
- Accession number :
- edsair.doi.dedup.....d70f7c26489bf710ff9554b9347b7bea
- Full Text :
- https://doi.org/10.1016/j.prosdent.2018.03.004