I would agree with Dr. Weaver that there are ongoing controversies concerning connecting implants to teeth. In my article, the purpose of this section was to review the fact that it is not considered common practice to routinely connect teeth to implants, though there are times when anatomical limitations, patient’s desires or costs necessitate this approach. It should be done with care, using rigid framework designs and with informed consent of the patient.
The literature contains numerous citations (commonly, case reports or serial case series) that cite acceptable outcomes with prosthetic connection between implants and teeth, though concern has been raised with two recent systematic evidence-based reviews.
In one, a prospective, randomized clinical trial was performed indicating an elevated incidence of complications.1 A systematic review of the entire dental literature (The Cochrane Collaboration, "www.cochrane.org/docs/descrip.htm") and the recent systematic review of dental implant systems2 also raise concerns about the clinical concept of connecting teeth to implants.
Dr. Weaver is correct that many clinical procedures are controversial, and this places on the clinician the responsibility to plan the restorative treatment carefully, using materials and procedures supported by the current best evidence.
TOP
REFERENCES
