Interproximal Open Contacts Between Implant Restorations and Adjacent Teeth. Prevalence – Causes – Possible Solutions

Abstract

Purpose To present the prevalence and contributing factors of interproximal contact loss (ICL) between implant restorations and adjacent teeth, and to provide recommendations for possible prevention and treatment of this complication. Materials and Methods The authors explored the dental literature on PubMed on ICL between implants and adjacent teeth, interproximal contacts, open contacts, teeth migration causes, facial bone formation, and facial bone changes. Results ICL between fixed implant prostheses and adjacent teeth has been reported. A literature search revealed 7 studies showing a high prevalence of ICL between implant prostheses and adjacent teeth. The literature indicates that this ICL is greater in the mesial aspect in comparison with the distal. As identified by the literature review, ICL in the maxilla ranged between 18% and 66% versus 37% to 54% in the mandible. ICL might occur as early as 3 months after prosthetic treatment. The literature review documented possible tooth migration causes, crown‐related causes, and bone formation/growth‐related causes of ICL. Conclusions ICL is a common multifactorial implant complication. The clinical condition will dictate if the implant crown needs to be modified/replaced or the natural tooth needs to be restored to reestablish interproximal contact between an implant prosthesis and adjacent tooth. Periodic evaluations of interproximal contacts between implant restorations and the adjacent teeth and the use of screw‐retained restorations due to ease of removal is recommended to diagnose and mitigate the problem. An orthodontic retainer or occlusal guard may help prevent ICL between the implant restoration and the adjacent tooth.

Breaking the wave of peri‐implantitis

“…It was reported that the occurrence was 18%-66% and 37%-54% in the maxilla and mandible, respectively. 172 It is evident from these studies that regular review of the occlusal contacts to ensure light contacts on the implant restorations to avoid occlusal overloading is important. 171 In addition, delivery of an occlusal guard may be helpful in maintaining the positions of the teeth in the arch.…”

Evaluation of adjacent tooth displacement in the posterior implant restoration with proximal contact loss by superimposition of digital models

“…This study was conducted to analyze displacement of adjacent natural teeth, which is the cause of ICL12 in the posterior implant restoration in patients who suffered from food impaction. For comparison of visual and quantitative chronologic change, an initial dental cast of delivery and a dental cast of ICL after function were scanned respectively, and digital models were superimposed on each other.…”

“…Food impaction from interproximal contact loss (ICL) between implant prostheses and adjacent natural teeth was a recently reported complication in the partially edentulous patient 891011. Although this is a multifactorial complication from tooth migration, crown-related cause and bone formation/growth-related cause,12 interproximal contact loss phenomenon was related mainly with the tendency of mesial drift of natural tooth1314 in the posterior region. Mesial tilting of tooth and anterior component of occlusal force were supposed as primary causes of inherent mesial drift of tooth in human being 151617.…”

Etiology and classification of food impaction around implants and implant‐retained prosthesis

“…Another potential etiology of food impaction around an implant is the loss of interimplant papilla due to overemphasized gingival embrasures and faulty contact and contour of the implant prosthesis. The vertical and horizontal position of the implant in relation to the adjacent tooth significantly influence the level of the interdental or interimplant bone . Both over‐contoured and under‐contoured restorations/prosthesis alter the morphology of the gingival embrasure, violate biologic width, and injure the interdental or interimplant papilla with the marginal bone loss in the interdental region.…”

“…A square‐shaped implant prosthesis with flat and broad proximal contact area favor more food impaction compared to a properly contoured implant restoration . Thus, it is important to assess the position of the implant in relation to the adjacent tooth, the distance between the contact point and crest of the alveolar bone, condition of adjacent teeth, mesial and vertical migration of the adjacent teeth, and amount of interdental and interimplant bone height before placement of implants and fabrication of implant prosthesis . The loss of marginal bone and violation of biologic width around implants should be avoided as it can indirectly influence the level of the interdental papilla and degree of food impaction …”