M. Gross et Bz. Laufer, SPLINTING OSSEOINTEGRATED IMPLANTS AND NATURAL TEETH IN REHABILITATION OF PARTIALLY EDENTULOUS PATIENTS .1. LABORATORY AND CLINICAL-STUDIES, Journal of oral rehabilitation, 24(11), 1997, pp. 863-870
A significant clinical consideration in the restoration of partial ede
ntulism with implant and tooth-supported prostheses is whether implant
s and natural teeth abutments should be splinted, and if so, in what m
anner. This article presents a review of laboratory and clinical studi
es related to splinting. Stress analysis studies reveal high stress co
ncentration around the implant neck when rigidly connected to teeth. T
his was not borne out in in vivo studies in short-span bridges. While
stress absorbing elements have been advocated to redistribute and redu
ce stress concentration away from the implant neck where bone resorpti
on is often seen, finite element analysis and photo-elastic studies de
monstrate that such stress absorbing elements may be effective only wh
en their resiliency is in the same order of magnitude as the periodont
al Ligament. Clinical studies reporting life table statistics in combi
ned implant and tooth restorations do not show adverse effects of spli
nting teeth to implants. These studies, however, are mostly short-term
reports oh survival with results that are as yet inconclusive. The is
sue of connecting with rigid or non-rigid connectors remains unresolve
d with a growing body of information favouring retrievable short-span
rigid connection to non-mobile teeth. Root intrusion is a potential cl
inical hazard of non-rigid connection.