SPLINTING OSSEOINTEGRATED IMPLANTS AND NATURAL TEETH IN REHABILITATION OF PARTIALLY EDENTULOUS PATIENTS .1. LABORATORY AND CLINICAL-STUDIES

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.