Choosing between a splinted or non-splinted implant prosthesis should be based on solid scientific evidence that consider the condition and needs of each case. This review attempts to elaborate on the factors that directly influence the clinical decision between splinting or not splinting dental implants. An online and hand-search of the published literature was conducted to identify studies that examined splinted (SP) and non-splinted prostheses (NSP). The search terms that were used, alone or in combination, were “splinting prosthesis,” “non splinting prosthesis,” “prosthetic design,” “stress distribution in dental implant,” and “implant loading”, “implant occlusion”, “crestal bone resorption.” Ninety-four studies were selected for comparison and to 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 process of mechanical risk factors, finite element analysis FEA limits and implant survival and success criteria.

There are advantages and disadvantages of whether or not to splint implants together. Non splinted prostheses are the ideal choice because they resemble natural teeth. Splinting a restored implant will cause the implant to appear as one unit and is indicated in more compromised situations, unfavorable conditions or when pontics spaces and cantilevers are needed in implant prosthesis.

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