Connecting teeth to implants: a critical review of the literature and presentation of practical guidelines.

Historically, connecting a tooth to an implant to function as an abutment to replace a missing tooth was discouraged. It was believed differences in mobility patterns of a tooth and an implant would result in the prosthesis being cantilevered off the implant, thereby stressing the implant. Several papers concluded increased stress caused technical and biologic complications, which led to a decreased survival rate for a tooth-implant supported prosthesis (TISP) when compared with an implant-only supported prosthesis (ISP). However, problems attributed to TISPs may have been overstated. This paper reviews animal studies and human clinical trials that monitored successful use of TISPs. In addition, numerous issues are addressed that question the data, which have been interpreted to indicate that a tooth should not be connected to an implant. Recommendations are made to facilitate attaining high success rates with TISPs.