Esplintagem de próteses sobre implantes em segmentos posteriores

Abstract

Occlusal load and its distribution is considered to be one of the principal components that influences the success and failure on implant-supported restorations over time. The rationale of splinting in implant dentistry to minimize stress by increasing the resistance area over which the load is distributed is controversial. Many authors try to clarify this question through different tests and methods, like, finit element analysis, fotoelastic models analysis and clinical trails. The objective of this study was to review the literature to determine in which clinical situations there is indication for splinting implant-supported prostheses in later segments aiming at their longevity/maintenance of osseointegration. The decision to splint or not implantsupported prostheses depends on the type of connection, length and diameter of the implant, as well as crown/implant and the occlusion ratio, passivity, patient characteristics and the surgical technique. Implants splinted together does not have any negative effect on their longevity when the nesting structure is passive. Splinted prostheses generated more uniform strain distributions; however, the strain distribution data in many articles were not statistically different from what was seen for the nonsplinted prostheses. Anyway, there is no consensus on which standard prosthetic (splinting or not) is superior. This study was intended to, exactly, contribute to this clarification.