Avaliação clínica e radiográfica da influência da esplintagem protética em implantes extracurtos: um estudo clínico randomizado de boca dividida com acompanhamento de 3 anos

Abstract

The aim of this randomized split-mouth clinical trial was to evaluate the effect of splinting on survival rates and on the clinical and radiographic parameters associated with prostheses supported by extra-short implants in the posterior region of atrophic mandibles over a 3-year follow-up period. Sixty extra-short implants (5 mm in length) were placed in 13 participants. The type of prosthesis for each hemimandible was randomly assigned between groups (n = 30): Group NS, non-splinted crowns, and group S, splinted crowns. Plaque index (PI), sulcus bleeding on probing index (SBPI), peri-implant sulcus probing depth (PD), and vertical marginal bone remodeling (vMBR) were assessed immediately after prosthesis installation (T0) and at 6 (T1), 24 (T2), and 36 months (T3). A customized acrylic resin device was used to standardize radiographic images over time, and vMBR was measured using image processing software. Survival rates were analyzed using the Kaplan–Meier method and the Logrank test. The Mann–Whitney and Friedman tests were applied to PI and SBPI, whereas two-way repeated-measures analysis of variance was used for PD and vMBR. No significant difference was found between groups in survival rates, which were 100% and 96.6% for Groups S and NS, respectively. PI was significantly higher in Group S than in Group NS at T1 and T3. At T3, Group S also showed a significantly higher SBPI than Group NS. PD was significantly lower in Group S than in Group NS at all timepoints. No significant difference was observed between groups regarding vMBR. In both groups, vMBR was significantly higher at T1 than at T3. Extra-short implants with non-splinted crowns exhibited similar survival and vMBR rates to those of extra-short implants with splinted crowns over a 3-year follow-up period. Nonsplinted extra-short implants were associated with more effective biofilm control.