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

Abstract

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

Implant Survival Rate and Prosthetic Complications of Full-arch Implant-supported Fixed Prostheses In Edentulous Upper Jaws: A Cohort Study

“…This result can be associated with the effectiveness of passive solidifica-tion of the implants using a rigid metal bar, which allows for a more effective distribution of forces. Another possible explanation, although the possibility of managing the patient's hygiene is more complex, the presence of six implants that support the rehabilitation ensures greater stability of the result compared to 4 implants and one overdenture (3,20,21).…”

Short implants compared to regular dental implants after bone augmentation in the atrophic posterior mandible: umbrella review and meta-analysis of success outcomes

“…Concerning prosthetic aspects, a report and evaluation of splinting, as well as its characteristics, is required, as it further decreases bone stress, and consequently can improve predictability, impacting on the magnitude of the overall effect [ 9 , 95 , 97 - 99 ]. Similarly, the use of internal connections [ 100 ] and smaller diameters (platform switching) [ 101 ] could have a beneficial effect on MBL.…”

Implant prosthodontic design as a predisposing or precipitating factor for peri‐implant disease: A review

“…It is suggested that this may decrease stress concentration in the crestal bone around any one particular implant and assists in minimizing mechanical/technical implant complications 90 . Clinical studies, however, have found similar degrees of marginal bone loss and prosthetic complication rates between splinted and non‐splinted implant restorations 90–93 . Achieving a passive fit of splinted adjacent restorations can be challenging, particularly where implants with conical connections are involved.…”

“…90 Clinical studies, however, have found similar degrees of marginal bone loss and prosthetic complication rates between splinted and non-splinted implant restorations. [90][91][92][93] Achieving a passive fit of splinted adjacent restorations can be challenging, particularly where implants with conical connections are involved. Any resulting misfit at the implant-abutment connection may contribute to biological and mechanical complications.…”