Articles / Research


Why and When does Splinting Crowns and Bridges make Treatment Better for Patients


Emil L.A. Svoboda PhD, DDS

Why and When does Splinting Crowns and Bridges make Treatment Better for Patients Concepts Designed to Make Implant Treatment Better





Citation: Emil L.A. Svoboda PhD, DDS


Abstract: In Spectrum Implants October 2022 I introduced a few guidelines that I use to decide to splint implants within a fixed restoration or not. Let’s test them against the root causes of mechanical problems that put our patients at risk of biological problems such as peri-implant disease and implant failure.


From the literature, I understand that increasing size increases Prosthesis Dimensional Error (PDE) and can make it more difficult to see and manage the Tissue Effects (TE): Resistance to Displacement and the Gingival Effects. Hard and soft tissues can prevent the dentist from seating a prosthesis properly by getting wedged between connections or otherwise displace connecting parts from their intended trajectory. Let’s introduce another root cause of mechanical misfits called Incongruent Paths of Insertion (ICPOI). 2 This considers intraoral elements such as teeth, implants, and implant parts that all have unique paths of insertion that are unlikely to be microscopically congruent. Why microscopically? We know that implant manufacturers can make connecting parts at an accuracy of ± 5µ 3 and that the oral microbes that cause peri-implant disease are around 1 micron in diameter. To have parts fit together optimally, they need to have congruent paths of insertion, if there is a desire to make the prosthesis easily retrievable.

  • Abstract: Overly grandiose and poorly substantiated titles risk the take-away message that Dental Implants don’t work, as the “casual” reader may not investigate beyond the title and critically analyze the full publication. Such a conclusion could prevent dentists from considering dental implants as part of many viable treatment options that could benefit their patients. On the other hand, one may argue that this message may reduce the overly aggressive removal of natural teeth and bone in favor of replacement with Dental Implants. The purpose of this submission is to review the featured publications by Froum and Guarnieri et al. with the...

I welcome all your questions and comments. I hope this “Implant Essentials: The BIG Questions” segment of this journal will help guide you to a better understanding of your craft, so you can do the best possible job for your patients. Besides, it would probably give you more pleasure basking in the glory of success, rather than trying to manage disappointed patients with complications…..