Implant-supported versus tooth-implant-supported bridges

O ral implants are valuable tools in the prosthetic reconstruction of partially edentulous jaws. These reconstructions may be performed in two principally different ways: (1) free-standing implant-supported bridges (2) tooth-implant-supported bridges. The advantages and drawbacks of splinting teeth and implants have been discussed in the literature. The tooth-implant connections were early questioned as natural teeth – anchored by the periodontium – have a certain mobility, while implants, because of osseointegration, are immobile. Naert [1] reported favourably on splinting teeth and implants but stated that it should be done only in cases where there was a special reason to do so; the first choice should always be the freestanding bridge. Zarb and Schmitt [2] did not find any advantage in splinting implants to natural teeth and advocated free-standing bridges in all cases. Sullivan [3] discussed the possible inactivity of the periodontal membrane after tooth-implant connection and the risk of disuse atrophy of the periodontal ligament. He also discussed the possibility of implant overload if a rigid connection was used. The negative influence on the periodontium has been elucidated in two experimental studies. O ́Leary et al. [4] designed a study with the aim of evaluating how natural teeth are affected when splinted to implants. They used Beagle dogs and compared teeth splinted to implants with teeth splinted to other teeth. They concluded that a natural tooth with normal mobility may function satisfactorily as an abutment for a fixed partial denture in combination with a screw-type implant. In another experimental study, Biancu et al. [5] demonstrated similar results. No negative influence on natural teeth of splinting to implants could be demonstrated in this study either . Implant-supported versus tooth-implant-supported bridges