Comparison of Stress and Strain Distribution Around Splinted and Nonsplinted 6-mm Short Implants in Posterior Mandible

Meimandi, Mansour; Ardakani, Mohammad Reza Talebi; Amid, Reza; Motlagh, Amir Mahmoudi; Beheshti, Shahrzad

doi:10.1097/id.0000000000000709

Cited by 13 publications

(6 citation statements)

References 17 publications

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“…Studies using finite element analysis have suggested that splinted prostheses provide less strain and stress on the marginal bone surrounding short implants. 9,10 Similar results have also been confirmed in some clinical research, 11 where splinted posterior implants shorter than 8.5 mm had a higher survival rate than nonsplinted implants after an average follow-up time of 9.7 ± 3.7 years. Nevertheless, Tang et al 12 reported that no statistically significant difference was found in marginal bone loss between splinted and nonsplinted prostheses supported by short implants no more than 8 mm after 3 to 7 years of follow-up.…”

supporting

confidence: 76%

Survival Rates of Splinted and Nonsplinted Prostheses Supported by Short Dental Implants (≤8.5 mm): A Systematic Review and Meta‐Analysis

Yao

Cao

et al. 2021

Journal of Prosthodontics

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Purpose: To evaluate and compare the implant survival rates, marginal bone loss, and mechanical complications of prostheses supported by splinted and nonsplinted short implants (≤8.5 mm). Material and Methods: Electronic database (MEDLINE, CENTRAL, Web of Science, and EMBASE) and manual searches up to May 2021 were conducted to identify studies comparing splinted and nonsplinted short implants (≤8.5 mm). The primary outcome was implant survival rate. Secondary outcomes were marginal bone loss and mechanical complications. The quality of included studies and risk-of-bias were assessed according to the Newcastle-Ottawa Scale. A random-effects model was used to analyze the data. Results: Twelve studies fulfilled the inclusion criteria and featured 1506 short implants (596 nonsplinted and 910 splinted) with a follow-up time ranging from 1 to 16 years. Quantitative analysis found no statistically significant differences between splinted and nonsplinted short implants (≤8.5 mm) for survival rate (RR = 0.98; 95% CI 0.96, 1.01; p = 0.26)) and marginal bone loss (SMD = -0.08; 95% CI -0.23, 0.07; p = 0.28). Veneer chipping, abutment screw breakage, screw loosening, and loss of retention were reported in the selected studies as common complications. However, no statistically significant difference was found between splinted and nonsplinted short implants (RR = 0.56; 95% CI 0.20, 1.54; p = 0.26). Conclusions: Within the limitations of the present meta-analysis, it might be concluded that splinted short implants (≤8.5 mm) do not present superior performance in survival rate, marginal bone maintenance and prevention of mechanical complications compared with single-unit prostheses.Although the exact definition remains controversial, 1-3 short dental implants have been proven to be an acceptable solution for patients with limited alveolar bone height, which could substantially reduce treatment procedures, time, cost, and postoperative complications. 4,5 The survival rate of short implants is considered to be affected by a variety of factors. Implant factors include the lengths and surface treatments of implants and implant-abutment connection design. 6 Surgical and prosthetic factors include implant position (maxilla or mandible), surgical trauma, loading, etc. 6,7 Moreover, it is worth noting that selection of a suitable rehabilitation modality for short implants is also considered a crucial factor to maintain the long-term stability and success of short implants. 8

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confidence: 76%

Survival Rates of Splinted and Nonsplinted Prostheses Supported by Short Dental Implants (≤8.5 mm): A Systematic Review and Meta‐Analysis

Yao

Cao

et al. 2021

Journal of Prosthodontics

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“…Moreover, increasing the crown height space (CHS) can elevate tension in the periimplant bone [3]. Although increasing the diameter of the implant can alleviate strain, it may not necessarily decrease bone stress under both axial and oblique loads [4]. The mechanical stress tends to concentrate in the areas of bone closest to the implant, gradually decreasing towards the outer regions.…”

Section: Introductionmentioning

confidence: 99%

Comparative Study of Stress Distribution in Tissue Surrounding Dental Implant Flexure: Continuum vs Full Body Analysis

Elshourbagy

2024

Preprint

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The use of dental implants has surged in popularity as an effective solution for individuals dealing with tooth loss. A successful dental implant must possess several essential qualities. It must be biocompatible to prevent any adverse reactions or rejection by the body. Furthermore, osseointegration, the fusion of the implant with the surrounding bone tissue, is crucial for stability and support. The implant should also demonstrate strength and durability to withstand biting and chewing forces without fracturing. Its long-lasting design is pivotal for ensuring durability over time. Additionally, the size and shape of the implant should be carefully selected to suit the patient's unique jawbone and surrounding tissues. To deepen our comprehension of dental implant behavior, we conducted a comparative study between a full-body diagram and the traditional continuum model for implant modeling. Our investigation revealed that incorporating a full-body diagram provides a more reliable and accurate simulation of the implant's response under various loading conditions. Moreover, the adaptability in size and shape of dental implants allows for the placement of different crown shapes and sizes, preserving the aesthetic appeal of the patient's teeth. By grasping the essential characteristics of successful dental implants and utilizing advanced modeling techniques, we can improve the outcomes of dental implant procedures.

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“…8 Studies have suggested that splinted prostheses can help decrease the harmful stress and strain on the peri-implant bone. [9][10][11] A retrospective study found a higher survival rate for splinted posterior implants shorter than 8.5 mm compared to nonsplinted implants after an average follow-up time of 9.7 ± 3.7 years. 7 A recent systematic review and meta-analysis concluded that there was no difference in the marginal bone loss and prosthetic complications of splinted and nonsplinted implant restorations but splinted restorations were associated with decreased implant failure.…”

Section: Introductionmentioning

confidence: 99%

The effect of splinting crowns on multiple adjacent implants: a retrospective study

Seong,

Chea, DMD,

Evans MS

2024

JDHODT

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Purpose: The purpose of this study was to retrospectively evaluate the effects of splinting implant crowns against nonsplinted crowns on the failures and complications of multiple adjacent implants. Material and methods: A retrospective chart review was conducted of all registered implant patients treated at the University of Minnesota School of Dentistry from 1988 to 2018. A total of 2738 implants within 1171 sections of 890 patients were examined retrospectively using an inclusion criteria of (1) two or more adjacent implants (section) present and (2) implants were restored by splinted crowns (Splinted group) or nonsplinted (individual) crowns (Nonsplinted group). Results: An average follow-up interval was significantly longer (p < 0.0001) for Splinted (median 5.52 [IQR 1.97, 9.67] years) compared to Nonsplinted (3.76 [1.49, 6.54] years). Splinted group’s Hazard ratio (HR) for implant failure was 0.67 (95% CI 0.35–1.31, p = 0.24) relative to Nonsplinted, and estimated 5- and 10-year failures rates were 2.5 (1.3–3.7) vs. 3.0 (1.9–4.0)% and 8.7 (6.1–11.3) vs. 8.6 (5.7–11.3)%, respectively. Splinted group’s HR for total complication relative to Nonsplinted was 0.98 (95% CI 0.71–1.36, p = 0.92) and estimated 5- and 10-year complication rates were 24.7 (21.7-27.5) vs. 23.7 (21.1-26.3)% and 38.1 (34.2-41.7) vs. 42.1 (37.2-46.6)%, respectively. Three most common complications (Splinted/Nonsplinted, 10-year estimates) were crown decementation/dislodgement (20.8/13.0%), peri-implantitis (12.2/13.1%), and screw loosening (5.9/12.8%), while 3 failure causes (5-year estimates) were peri-implantitis (1.8/1.3%), implant fracture/metal collar flowering (0.3/1.1%), and soft tissue encapsulation (0.1/0.2%). When 380 Lifecore implants with higher failure rates (8.4% in 7.2 years) were excluded, the implant failure HR became lower 0.46 (0.22–0.99, p = 0.05) indicating significantly lower implant failure risk in Splinted compared to Nonsplinted, while the total complication HR did not change much 0.95 (0.64–1.40, p = 0.79). When compared per section, Splinted total complication HR went down to 0.75 (0.55–1.02, p = 0.07), indicating lower risk for complication in Splinted sections compared to Nonsplinted sections. Conclusion: The trends of implant therapy of multiple adjacent implants have changed over the last three decades. The effects of splinting crowns of multiple adjacent implants were not significant in reducing implant failures or total complications. However, when the Lifecore implants mainly used in Splinted group during earlier phase (1988 – 2003) were excluded, the Splinted group showed significantly lower implant failure risk than Nonsplined group.

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Comparison of Stress and Strain Distribution Around Splinted and Nonsplinted 6-mm Short Implants in Posterior Mandible

Abstract: Splinting adjacent short implants may provide less bone strain and stress, especially at the presence of lateral forces. Increasing the implant diameter may be effective in strain reduction, but does not seem to reduce the bone stress, regardless of the direction of the load applied.

Cited by 13 publications

References 17 publications

Survival Rates of Splinted and Nonsplinted Prostheses Supported by Short Dental Implants (≤8.5 mm): A Systematic Review and Meta‐Analysis

Survival Rates of Splinted and Nonsplinted Prostheses Supported by Short Dental Implants (≤8.5 mm): A Systematic Review and Meta‐Analysis

Comparative Study of Stress Distribution in Tissue Surrounding Dental Implant Flexure: Continuum vs Full Body Analysis

The effect of splinting crowns on multiple adjacent implants: a retrospective study

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