Title For Patients Who Receive A Mandibular Posterior Implant Restoration, A Higher Incidence of Loss of Proximal Contact Between Implant Restoration And Adjacent Natural Tooth Was Observed
Clinical Question In patients requiring a mandibular posterior implant restoration, should a clinician anticipate a loss of proximal contact strength over time, when compared to an all-natural dentition?
Clinical Bottom Line For patients who receive a mandibular posterior implant restoration, a higher incidence of loss of proximal contact between implant restoration and adjacent natural tooth was observed. These results are consistent with CAT #849 published in April 2011, which found that “Loss of proximal contact was observed between implant supported fixed prosthetics and adjacent natural teeth.”
Best Evidence  
PubMed ID Author / Year Patient Group Study type
(level of evidence)
26562738Greenstein/2016273 adult patients in 5 included studies.Systematic review of non-randomized trials
Key resultsIncidence of interproximal loss of contact between an implant restoration and adjacent natural tooth was higher than originally anticipated. The studies investigated in the systematic review provided evidence of an open contact forming in 34%-66% of cases where an implant was placed next to a natural adjacent tooth. The implant is believed to act like an ankylosed tooth which upon anterior vector forces and mesial drifting of the teeth will remain stationary resulting in a higher incidence of mesial contact loss occurring more commonly in the mandible than the maxilla.
Evidence Search Search ("Dental Implants, Single-Tooth"[Mesh]) AND "Dental Prosthesis, Implant-Supported"[Mesh]
Comments on
The Evidence
The authors of this article used information from 5 observational studies that assessed interproximal contact loss between an implant and adjacent tooth. A total of 273 patients were assessed in the clinical trials. They did not include control groups, and the presence of open contacts at time of implant placement was not always recorded. Data interpretation is therefor limited by the lack of consistency in the use of differential statistical methods by each of the 5 studies in addition to the use of unlike populations, duration in which the participants were monitored and tightness of the contact.
Applicability The 5 studies are relevant to a patient who has previously received a mandibular posterior dental implant or a patient contemplating an implant as a treatment option. The dental professional should inform the patient of adverse effects related to loss of proximal contact of the implant. Such consequences include, impacted food particles that can lead to development of caries, periodontal problems such as attachment loss and increased probing depths, tooth migration, and necessary repairs of the prosthesis. It is important to have the patient understand the risks associated with the procedure in order to assess his/her level of compliance.
Specialty (General Dentistry) (Prosthodontics)
Keywords implants; restorative dentistry; operative
ID# 3038
Date of submission 03/13/2016
E-mail marder@livemail.uthscsa.edu
Author Ariel Marder
Co-author(s) e-mail
Faculty mentor Kevin M. Gureckis, DMD
Faculty mentor e-mail gureckis@uthscsa.edu
Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?)
None available
Comments and Evidence-Based Updates on the CAT
None available