The choice of a splinted or nonsplinted implant-supported prosthesis should be based on solid scientific evidence that considers the conditions and needs of each patient. This review elaborates on the factors that directly influence clinical decisions between splinted or nonsplinted dental implants. Digital and manual searches of the published literature were conducted to identify studies that examined splinted prostheses (SPs) and nonsplinted prostheses (NSPs). The search terms used, alone or in combination, were “splinting prosthesis,” “nonsplinting prosthesis,” “prosthetic design,” “stress distribution in dental implant,” “implant loading,” “implant occlusion,” and “crestal bone resorption.” Ninety-four studies were selected to compare and address the details emphasized in this study. Thirty-four reported articles were not directly related to restoration design but were reviewed to better understand the influence of mechanical risk factors, finite element analysis limits, and criteria for implant survival and treatment success. There are advantages and disadvantages of splinting implants together. NSPs are the ideal choice because they resemble natural teeth. Splinting a restored implant will cause the implant to appear as part of one unit and is indicated in more compromised situations, unfavorable conditions, or when pontic spaces and cantilevers are needed in implant prostheses.

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