ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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Title Implant Restorations Have a Probability of Developing an Open Mesial and Distal Contact That Can Be Detected 1 Month to 12 Years After Placement
Clinical Question In patients with a single unit crown on a posterior tooth, is an implant restoration more likely to develop an open contact in the first 2 years of placement compared to a natural tooth restoration?
Clinical Bottom Line In patients receiving an implant restoration in the posterior region, the chances of developing an open mesial contact is 38% to 67% and an open distal contact is 16% to 25%. The open contact can be clinically detected from 1 month to 12 years after placement of the implant restoration.
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 26562738Greenstein/20165 studies/273 patientsSystematic review of non-randomized trials
Key resultsThis systematic review of cohort studies includes 5 studies with 273 patients and 501 contacts assessed. The probability of an open contact developing on an implant-restored tooth that is placed next to a natural tooth was 34% to 66%. The open contact was detected 1 month to 12 years post-placement. The percentage of implant restored teeth developing open proximal contacts adjacent to natural teeth on the mesial surface was 38% to 67% and on the distal surface was 16% to 25%. The open mesial contact is thought to arise from the anterior component of force (ACF) that drives teeth mesially and the implant restoration being analogous to an ankylosed tooth. The cause of an open distal contact is still unknown. After the detection of an open contact, treatment guidelines for clinicians were described in the article in further detail.
Evidence Search ("dental implants"[MeSH Terms] OR ("dental"[All Fields] AND "implants"[All Fields]) OR "dental implants"[All Fields] OR ("dental"[All Fields] AND "implant"[All Fields]) OR "dental implant"[All Fields]) AND open[All Fields] AND ("Contact"[Journal] OR "contact"[All Fields] OR "Contact"[Journal] OR "contact"[All Fields])
Comments on
The Evidence
Validity: This was a systematic review of 5 cohort, observational studies. The selection criteria for the studies that were included were trials in which the dimensions (size and quality) of the contact and the follow-up time were recorded. A total of 45 articles were assessed, and 5 studies with 273 patients were included. Perspective: The open contact points in the included studies were measured with 3 different materials: 2 studies used a 50 µm strip, 2 studies used dental floss, and 1 study used a 38-µm Toffelmire matrix band. There may be some discrepancies in the quality of the contact depending on which material was used to check the contact. In some studies, an open distal contact was reported but the reason for this occurrence is unknown. The evidence for the development of an open mesial contact is consistent with the current perspective of an implant restoration having the same function and properties as an ankylosed tooth. Lastly, per the article's authors, "in all 5 articles in which the authors addressed the incidence of open contacts, other quadrants without implants were not used as control groups; therefore, we do not precisely know whether the incidence of open contacts was statistically significantly greater adjacent to implants than when an implant was not placed."
Applicability The evidence is applicable to any patient receiving an implant restoration, especially in the posterior regions. Special considerations and care should be taken for patients with high caries risk, malocclusion, bruxism, and continuing facial growth.
Specialty/Discipline (General Dentistry) (Prosthodontics) (Restorative Dentistry)
Keywords Dental Impants with Open Contact, Open Diastema, Ankylosed Teeth
ID# 3004
Date of submission: 03/29/2016spacer
E-mail schuchartc@livemail.uthscsa.edu
Author Chris Schuchart
Co-author(s)
Co-author(s) e-mail
Faculty mentor/Co-author David Cox, DDS
Faculty mentor/Co-author e-mail CoxD@uthscsa.edu
Basic Science Rationale
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