Open contacts adjacent to posterior dental implants: Current understanding and emerging preventive concepts

Area of Science:

• Dental Implantology
• Prosthodontics
• Biomaterials Science

Background:

• Open proximal contacts between posterior dental implants and adjacent teeth are frequent complications.
• These issues stem from biomechanical, prosthetic, surgical, and occlusal factors, alongside natural tooth movement.

Purpose of the Study:

• To review the causes and consequences of open proximal contacts in posterior implant restorations.
• To evaluate current preventive and corrective strategies and introduce novel approaches.

Main Methods:

• Literature review examining multifactorial etiology, clinical consequences, and treatment strategies.
• Introduction of biomechanically informed occlusal adjustment concepts, specifically the mesial-mesial/distal-distal (MM-DD) technique.

Main Results:

• Open contacts lead to food impaction, gingival inflammation, bone loss, and reduced patient satisfaction.
• Existing strategies have limitations in long-term effectiveness.
• Preliminary data suggests the MM-DD technique may preserve proximal contact integrity.

Conclusions:

• Open proximal contacts present significant clinical challenges impacting oral health and implant longevity.
• The MM-DD technique offers a potential proactive solution, requiring further prospective validation.
• Enhancing long-term stability of proximal contacts is crucial for successful posterior implant therapy.