title: Clinical evaluation of marginal bone level change of multiple adjacent implants restored with splinted and nonsplinted restorations: a 5-year prospective study.
abstract: OBJECTIVE
  The success of single-tooth implant restorations has resulted in an increased use of nonsplinted implants to replace adjacent missing teeth; however, this may result in excessive force transmission to the implant and bone, causing bone loss. The purpose of this prospective study was to compare the marginal bone level change of adjacent splinted implants and of nonsplinted implants functionally loaded with cemented restorations up to 5 years in maxillae.
  
  
  METHODS
  Between 2002 and 2004, all patients who received three consecutive adjacent implants in a private office and a university implant dentistry department were included in this study. All implants were placed in posterior maxillae. Maxillary left implants were restored with splinted cemented restorations, and maxillary right implants were restored with nonsplinted cemented restorations. Marginal bone resorption was measured with intraoral radiographs annually for 5 years. The data were analyzed statistically with the Mann-Whitney U test and the two-sample Kolmogorov-Smirnov test to identify differences between splinted and nonsplinted implant restorations.
  
  
  RESULTS
  One hundred thirty-two implants were placed in 44 patients. Two subjects (6 implants in total) did not complete the study. Three implants failed at stage-two surgery. Of the remaining 123 implants, 63 were restored with splinted cemented restorations and 60 were restored with nonsplinted cemented restorations. The mean marginal bone level changes at the 5-year recall were -0.7 ± 0.2 mm for splinted restorations and -0.8 ± 0.2 mm) for nonsplinted restorations.
  
  
  CONCLUSIONS
  Peri-implant marginal bone loss around nonsplinted implants in the present study was statistically equivalent to that observed in splinted implants. Multiple nonsplinted implants can be successfully included in many clinical situations in an effort to optimize esthetics and circumvent the problem of nonpassively fitting frameworks.
authors.affiliation: Department of Clinical Odontostomatology, University of Padova, Padova, Italy. paolovigolo@virgilio.it
authors.forename: Paolo
authors.initials: P
authors.lastname: Vigolo
authors.forename: Massimiliano
authors.initials: M
authors.lastname: Zaccaria
mesh_terms: D000328:Adult; D016301:Alveolar Bone Loss / Q000209:etiology / Q000473:pathology*; D001862:Bone Resorption / Q000209:etiology / Q000473:pathology; D000044:Dental Abutments; D003758:Dental Implantation, Endosseous / Q000295:instrumentation / Q000379:methods; D019250:Dental Implants, Single-Tooth / Q000009:adverse effects*; D017267:Dental Prosthesis Design; D019094:Dental Prosthesis, Implant-Supported / Q000009:adverse effects* / Q000295:instrumentation; D019232:Dental Restoration Failure; D003793:Dental Restoration, Permanent / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods; D003830:Denture, Partial, Fixed / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007576:Jaw, Edentulous, Partially / Q000473:pathology / Q000534:rehabilitation; D008297:Male; D008437:Maxilla / Q000473:pathology; D008875:Middle Aged; D011446:Prospective Studies; D013165:Splints; D018709:Statistics, Nonparametric; D016896:Treatment Outcome