대한치과의사협회지 (The Journal of the Korean dental association)

  • 제54권3호
  • /
  • Pages.198-205
  • /
  • 2016
  • /
  • 0376-4672(pISSN)
  • /
  • 2713-7961(eISSN)
대한치과의사협회 (The Korean Dental Association)
권호 표지

Splinted or Non-splinted: 다수의 인접한 치아 결손부 수복을 위한 임플란트 보철

Splinted and non-splinted implant-supported restorations : prosthetic considerations for restoring multiple adjacent teeth

  • 윤형인 (이화여대 목동병원 치과보철과)
  • Yoon, Hyung-In (Department of Dentistry, School of Medicine, Ewha Womans University)
  • 투고 : 2016.01.22
  • 심사 : 2016.02.12
  • 발행 : 2016.03.01
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

The purpose of this paper was to investigate the significance of splinted and non-splinted implant-supported restorations with an internal connection for multiple consecutively missing teeth. Upon examination of the effects of fixture-abutment connection, the distribution of occlusal load was favorable in splinted implant-prosthesis with an external connection, but effect of strain distribution was not significant in splinted implant-prosthesis with an internal connection. In splinted implant-prostheses for short implants, strain distribution was not affected by the method of retention. For cement-retained prostheses, the effect of strain distribution due to splinting was not significant. In clinical studies, non-splinted prostheses with an internal connection for multiple consecutively missing teeth showed high survival rate, mild marginal bone loss, and stable periodontal condition. However, failure to achieve optimal proximal contact between single-unit prostheses may lead to food impaction, and veneer fracture may be inevitable when the framework provides inadequate support in the proximal region. In conclusion, splinted implant-prosthesis is not an indication in all cases, and clinical consideration of its use should be based on the patient's oral condition, such as location and number of implants, formation of proximal contact, canine guidance, existence of parafunctional habit, and oral hygiene, when multiple consecutively missing teeth are replaced by internal connection type implant.

키워드

참고문헌

  1. Nyman, S.R. and N.P. Lang, Tooth mobility and the biological rationale for splinting teeth. Periodontol 2000, 1994. 4: p. 15-22. https://doi.org/10.1111/j.1600-0757.1994.tb00002.x
  2. Geng, J.P., K.B. Tan, and G.R. Liu, Application of finite element analysis in implant dentistry: a review of the literature. J Prosthet Dent, 2001. 85(6): p. 585-98. https://doi.org/10.1067/mpr.2001.115251
  3. Brunski, J.B., Biomechanical factors affecting the bone-dental implant interface. Clin Mater, 1992. 10(3): p. 153-201. https://doi.org/10.1016/0267-6605(92)90049-Y
  4. Brunski, J.B., D.A. Puleo, and A. Nanci, Biomaterials and biomechanics of oral and maxillofacial implants: current status and future developments. Int J Oral Maxillofac Implants, 2000. 15(1): p. 15-46.
  5. Rangert, B.R., R.M. Sullivan, and T.M. Jemt, Load factor control for implants in the posterior partially edentulous segment. Int J Oral Maxillofac Implants, 1997. 12(3): p. 360-70.
  6. Becker, C.M., D.A. Kaiser, and J.D. Jones, Guidelines for splinting implants. J Prosthet Dent, 2000. 84(2): p. 210-4. https://doi.org/10.1067/mpr.2000.108672
  7. Guichet, D.L., D. Yoshinobu, and A.A. Caputo, Effect of splinting and interproximal contact tightness on load transfer by implant restorations. J Prosthet Dent, 2002. 87(5): p. 528-35. https://doi.org/10.1067/mpr.2002.124589
  8. Nissan, J., et al., The effect of crown/implant ratio and crown height space on stress distribution in unsplinted implant supporting restorations. J Oral Maxillofac Surg, 2011. 69(7): p. 1934-9. https://doi.org/10.1016/j.joms.2011.01.036
  9. Nissan, J., et al., The effect of splinting implantsupported restorations on stress distribution of different crown-implant ratios and crown height spaces. J Oral Maxillofac Surg, 2011. 69(12): p. 2990-4. https://doi.org/10.1016/j.joms.2011.06.210
  10. Tiossi, R., et al., Comparison of the correlation of photoelasticity and digital imaging to characterize the load transfer of implant-supported restorations. J Prosthet Dent, 2014. 112(2): p. 276-84. https://doi.org/10.1016/j.prosdent.2013.09.029
  11. Tiossi, R., et al., Digital image correlation analysis of the load transfer by implant-supported restorations. J Biomech, 2011. 44(6): p. 1008-13. https://doi.org/10.1016/j.jbiomech.2011.02.015
  12. Sang-Hyun Baik, I.-T.J., Sung-Kyun Kim, Jai-Young Koak, Seong-Joo Heo, A three-dimensional finite-element analysis of influence of splinting in mandibular posterior implants. The Journal of Korean Academy of Prosthodontics, 2008. 46(2): p. 157-168.
  13. Clelland, N.L., et al., Comparison of strains for splinted and nonsplinted implant prostheses using three-dimensional image correlation. Int J Oral Maxillofac Implants, 2010. 25(5): p. 953-9.
  14. Yilmaz, B., J.D. Seidt, and N.L. Clelland, Displacement of screw-retained splinted and nonsplinted restorations into implants with conical internal connections. Int J Oral Maxillofac Implants, 2014. 29(6): p. 1289-92. https://doi.org/10.11607/jomi.3612
  15. Yilmaz, B., et al., Comparison of strains for splinted and nonsplinted screw-retained prostheses on short implants. Int J Oral Maxillofac Implants, 2011. 26(6): p. 1176-82.
  16. Clelland, N.L., B. Yilmaz, and J.D. Seidt, Threedimensional image correlation analyses for strains generated by cement and screw-retained implant prostheses. Clin Implant Dent Relat Res, 2013. 15(2): p. 271-82. https://doi.org/10.1111/j.1708-8208.2011.00411.x
  17. Yilmaz, B., et al., Strain comparisons for splinted and nonsplinted cement-retained implant crowns. Int J Prosthodont, 2013. 26(3): p. 235-8. https://doi.org/10.11607/ijp.3254
  18. Solnit, G.S. and R.L. Schneider, An alternative to splinting multiple implants: use of the ITI system. J Prosthodont, 1998. 7(2): p. 114-9. https://doi.org/10.1111/j.1532-849X.1998.tb00190.x
  19. Simon, R.L., Single implant-supported molar and premolar crowns: a ten-year retrospective clinical report. J Prosthet Dent, 2003. 90(6): p. 517-21. https://doi.org/10.1016/j.prosdent.2003.08.025
  20. Norton, M.R., Multiple single-tooth implant restorations in the posterior jaws: maintenance of marginal bone levels with reference to the implant-abutment microgap. Int J Oral Maxillofac Implants, 2006. 21(5): p. 777-84.
  21. Blanes, R.J., et al., A 10-year prospective study of ITI dental implants placed in the posterior region. II: Influence of the crown-to-implant ratio and different prosthetic treatment modalities on crestal bone loss. Clin Oral Implants Res, 2007. 18(6): p. 707-14. https://doi.org/10.1111/j.1600-0501.2006.01307.x
  22. Vigolo, P., et al., Clinical evaluation of marginal bone level change around multiple adjacent implants restored with splinted and nonsplinted restorations: a 10-year randomized controlled trial. Int J Oral Maxillofac Implants, 2015. 30(2):p. 411-8.
  23. Lee, J.T., et al., Consecutive unsplinted implantsupported restorations to replace lost multiple adjacent posterior teeth: A 4-year prospective cohort study. Acta Odontol Scand, 2015. 73(6): p. 461-6. https://doi.org/10.3109/00016357.2014.983543
  24. Grossmann, Y., I.M. Finger, and M.S. Block, Indications for splinting implant restorations. J Oral Maxillofac Surg, 2005. 63(11): p. 1642-52. https://doi.org/10.1016/j.joms.2005.05.149
  25. Naert, I., et al., Biologic outcome of implantsupported restorations in the treatment of partial edentulism. part I: a longitudinal clinical evaluation. Clin Oral Implants Res, 2002. 13(4): p. 381-9. https://doi.org/10.1034/j.1600-0501.2002.130406.x
  26. Naert, I., et al., Biologic outcome of implantsupported restorations in the treatment of partial edentulism. Part 2: a longitudinal radiographic study. Clin Oral Implants Res, 2002. 13(4): p. 390-5. https://doi.org/10.1034/j.1600-0501.2002.130407.x