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Proximal Contact Loss in Implant-Supported Restorations
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Loss of interproximal contacts of implant restorations are perhaps one of the most common implant prosthetic complications which can lead to food impaction and possibly peri-implantitis. A systematic review examined 15 studies including 11,699 implants. The loss of interproximal contacts were found to be 20% at the implant-restoration level and 26% at the contact point level. The loss of interproximal contacts were more prevalent in the mesial than the distal contacts, while approximately the same when compared between maxillary and mandibular arches.
- Loss of interproximal contact is a frequent complication associated with implant prostheses. Clinicians should frequently check the interproximal contacts of implant–implant or implant–natural tooth to prevent further complications due to food impaction.
abstract
This abstract is available on the publisher's site.
Access this abstract nowPURPOSE
This is a systematic review and meta-analysis to estimate the overall prevalence of Proximal Contact Loss (PCL) and determine the distribution and clinical features of proximal contact loss.
METHODS
This systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. As this was a systematic review of prevalence, the condition, context, and population framework was followed. The focus question was: What is the prevalence and distribution of PCL in implant-supported restorations? Two investigators independently examined the literature in four databases (Medline, Scopus, Web of Science, and Cochrane) for suitable articles published before November 11, 2020, with no start-date restriction; an additional search was conducted by hand. A standardized data extraction chart was utilized to extract the relevant information from the selected studies.
RESULTS
Fifteen studies met the inclusion criteria. A total of 11,699 restorations were evaluated in the final sample. The overall prevalence was 20% at the implant-restoration level (among 4984 implants) and 26.6% at the contact point level (among 2603 contact points). The frequency of proximal contact loss was higher on the mesial side, both at the implant-restoration level (13.8%) and at the contact point level (21.9%), than on the distal side, where the prevalence was 3.3% and 11.0%, respectively. The event rate in the maxilla and in the mandible at the contact level was 21.4% and 21.9%, respectively.
CONCLUSIONS
Proximal contact loss is a frequent complication. Approximately, 29% of contact points develop this condition, which may cause food impaction and damage to the interproximal tissues.
Additional Info
Disclosure statements are available on the authors' profiles:
Proximal Contact Loss in Implant-Supported Restorations: A Systematic Review and Meta-Analysis of Prevalence
J Prosthodont 2021 Jul 15;[EPub Ahead of Print], PF Manicone, P De Angelis, E Rella, L Papetti, A D'AddonaFrom MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.
Since the introduction of endosseous dental implants in the United States in the mid-1980s as a routine intervention to restore edentulous sites, outcome success rates have been reported in the mid-90% range and higher, making these procedures very predictable and acceptable by the public at large as a quality-of-life enhancement. With that said, these interventions do not come without complications, which have been comprehensively reported in the past.1 Only within the last few years have there been reports on the complications of open contacts or proximal contact loss (PCL). This systematic review and meta-analysis by the Italian group of Manicone et al report on the prevalence and clinical characteristics of this complication following the PRISMA guidelines for systematic reviews (Preferred Reporting Items for Systematic Reviews and Meta Analysis). One of the strengths of this report is the use of this more rigorous approach to study the incidence of a condition or disease in a population where the standalone cohort or cross-sectional study design is typically followed. The use of systematic reviews of prevalence has gained significant traction in the last few years, resulting in improved data from which to inform consumers, providers, and policy makers.2 A total of 15 out of the original 927 articles met inclusion criteria, resulting in a total of 11,699 restorations evaluated, albeit with a relatively high level of heterogeneity among the articles that were included; the heterogeneity was the major limitation of this report. With that said, surprisingly, the incidence of open contacts between implant-supported restorations and natural teeth was greater than 30% after various time periods, where it became a more common finding the longer the restoration had been in service beginning between 2 and 5 years in function. The etiology was discussed but inconclusive.
References