title: Clinical evaluation of marginal bone level change around multiple adjacent implants restored with splinted and nonsplinted restorations: a 10-year randomized controlled trial.
abstract: OBJECTIVE
  The management of occlusal forces on implant restorations may influence their long-term prosthetic success. The purpose of this randomized controlled trial was to compare marginal bone level changes around adjacent splinted and nonsplinted implants, functionally loaded with cemented restorations, up to 10 years in maxillae.
  
  
  METHODS
  During 2002 and 2003, all patients who received three adjacent implants in a private office and a university setting were included in this study. All implants featured an external-hexagon design and were placed in the posterior maxilla. Implants in the left maxilla were randomly selected to be restored with splinted cemented restorations; maxillary right implants were restored with nonsplinted cemented restorations. Marginal bone resorption was measured with intraoral radiographs yearly over a period of at least 10 years after placement of abutments and restorations. The amount of bone loss in each group was analyzed with the two-sample Wilcoxon rank-sum (Mann-Whitney) test because variable bone loss was normally distributed at the fifth year only.
  
  
  RESULTS
  One hundred thirty-two implants were placed in 44 patients. Three implants failed at stage-two surgery. Five years after initial loading, two patients moved away and were lost to follow-up (6 implants in total); three additional patients did not complete the study (9 implants in total). Of the remaining 114 implants, 60 left implants were restored with splinted cemented restorations and 54 right implants were restored with nonsplinted cemented restorations. At 10 years, the splinted group showed a mean of 1.2 mm (interquartile range: 0.2 mm) of bone loss; the nonsplinted group showed 1.3 mm (interquartile range: 0.2 mm).
  
  
  CONCLUSIONS
  A significant difference in bone loss was seen between the two groups. However, the difference of 0.1 mm was not considered clinically meaningful.
authors.forename: Paolo
authors.initials: P
authors.lastname: Vigolo
authors.forename: Sabrina
authors.initials: S
authors.lastname: Mutinelli
authors.forename: Massimiliano
authors.initials: M
authors.lastname: Zaccaria
authors.forename: Edoardo
authors.initials: E
authors.lastname: Stellini
mesh_terms: D000328:Adult; D000368:Aged; D016301:Alveolar Bone Loss / Q000209:etiology*; D001862:Bone Resorption; D015921:Dental Implants; D019094:Dental Prosthesis, Implant-Supported / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D008437:Maxilla / Q000601:surgery*; D008875:Middle Aged; D008963:Molar / Q000601:surgery; D011474:Prosthesis Design; D013165:Splints
chemical_list: D015921:Dental Implants