J Adv Prosthodont.  2016 Dec;8(6):494-503. 10.4047/jap.2016.8.6.494.

The prognosis of splinted restoration of the most-distal implants in the posterior region

• Lee JB
• Kim MY
• Kim CS
• Kim YT

• KMID: 2382596
• DOI: http://doi.org/10.4047/jap.2016.8.6.494

Abstract

PURPOSE
The aim of this study was to compare the efficacies of two-implant splinting (2-IS) and single-implant restoration (1-IR) in the first and second molar regions over a mean functional loading period (FLP) of 40 months, and to propose the appropriate clinical considerations for the splinting technique.
MATERIALS AND METHODS
The following clinical factors were examined in the 1-IR and 2-IS groups based on the total hospital records of the patients: sex, mean age, implant location, FLP, bone grafting, clinical crown-implant ratio, crown height space, and horizontal distance. The mechanical complications [i.e., screw loosening (SL), screw fracture, crown fracture, and repeated SL] and biological complications [i.e., peri-implant mucositis (PM) and peri-implantitis (PI)] were also evaluated for each patient. In analysis of two groups, the chi-square test and Student's t-test were used to identify the relationship between clinical factors and complication rates. The optimal cutoff value for the FLP based on complications was evaluated using receiver operating characteristics analysis.
RESULTS
In total, 234 patients with 408 implants that had been placed during 2005 - 2014 were investigated. The incident rates of SL (P<.001), PM (P=.002), and PI (P=.046) differed significantly between the 1-IR and 2-IS groups. The FLP was the only meaningful clinical factor for mechanical and biological complication rates in 2-IS.
CONCLUSION
The mechanical complication rates were lower for 2-IS than for 1-IR, while the biological complication rates were higher for 2-IS. FLP of 39.80 and 46.57 months were the reference follow-up periods for preventing biological and mechanical complications, respectively.

Keyword

Implant restoration; Splinted restoration; Posterior region; Complication rates; Functional loading period

MeSH Terms

Bone Transplantation
Crowns
Follow-Up Studies
Hospital Records
Humans
Molar
Mucositis
Peri-Implantitis
Prognosis*
ROC Curve
Splints*

Figure

• 

  Fig. 1 Receiver operating characteristics (ROC) curve of functional loading period (FLP) in the 2-IS group. (A) ROC curve of FLP for mechanical complications. The area under the ROC curve (AUC) was 0.725 (> 0.5 is a reliable value), and the optimal cutoff value of 46.57 months (95% confidence interval, 0.61 - 0.84) yielded a sensitivity of 69.2% and a specificity of 69.7%. (B) ROC curve of FLP for biological complications. AUC was 0.615 (> 0.5 is a reliable value), and the optimal cutoff value of 39.80 months (95% confidence interval, 0.49 - 0.74) yielded a sensitivity of 54.5% and a specificity of 54.9%.

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