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Proximal Contact Loss in Implant-Supported Restorations: A Systematic Review and Meta-Analysis of Prevalence
Paolo Francesco Manicone1, Paolo De Angelis1, Edoardo Rella1
1Department of Head and Neck and Sensory Organs, Division of Oral Surgery and Implantology, Fondazione Policlinico Universitario A. Gemelli IRCCS-Università Cattolica del Sacro Cuore, Rome, Italy.
Purpose:
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 PCL.
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 PCL 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:
PCL is a frequent complication. Approximately 29% of contact points develop this condition, which may cause food impaction and damage to the interproximal tissues.
