Open Proximal Contact with Implant-Supported Fixed Prostheses Compared with Tooth-Supported Fixed Prostheses: A Systematic Review and Meta-analysis

PURPOSE: To investigate the odds of developing open proximal contact (OPC) between implant-supported fixed prostheses and adjacent teeth compared with that between tooth-supported fixed prostheses and adjacent teeth.
MATERIALS AND METHODS: A search was conducted in the Ovid MEDLINE, Embase, and Web of Science databases for clinical studies on OPC developed with implant-supported prostheses or tooth-supported prostheses. A meta-analysis was performed using statistical software to estimate the odds of developing OPC with implant-supported prostheses compared with tooth-supported prostheses, with a 95% confidence interval (CI). The statistical significance was defined as P < .05.
RESULTS: The odds ratio (OR) of developing OPC with implant-supported prostheses was 2.46 compared with tooth-supported prostheses (95% CI [1.21 to 5.01]; P = .013]. However, the data were highly heterogenous (τ(2) = 0.40, I(2) = 95.67%). The total estimates of developing OPC were 41% (95% CI [30% to 54%]) with implant-supported prostheses and 22% (95% CI [18% to 26%]) with tooth-supported prostheses. OPC was more prevalent at the mesial side than at the distal side of implant-supported prostheses (OR = 2.38, 95% CI [0.94 to 6]; P = .066), whereas OPC was more prevalent at the distal side than at the mesial side of tooth-supported prostheses (OR = 1.94, 95% CI [1.09 to 3.45]; P = .024). There was no statistically significant difference in developing OPC with covariates of sex, age, arch, splinting of implants or adjacent teeth, region, and vitality of adjacent teeth, retention type, opposing dentition, occlusal force, parafunctional activities, and follow-up time. OPC was found to increase 9% per year with implant-supported prostheses (OR = 1.09). The estimate of interproximal gap next to implant-supported prostheses was 245.8 μm (95% CI [86.4 to 405.3 μm]).
CONCLUSION: Within the limitations of this systematic review and meta-analysis, the odds of developing OPC were significantly higher with implant-supported prostheses than with tooth-supported prostheses. However, the data were highly heterogenous, and thus, a well-designed randomized clinical study needs to be conducted to validate the results of this systematic review.