Frequency of infraposition and missing contact points in implant-supported restorations within natural dentitions over time: A systematic review with meta-analysis

OBJECTIVES The aim of this systematic review was to assess clinical evidence on adverse effects of osseointegrated implants placed among natural teeth of a residual dentition. METHODS Seven databases were searched without restrictions up to January 2018 for clinical studies on implant infraposition (IIP) or proximal contact point (PCP) loss to the adjacent teeth. After duplicate selection, data extraction, and risk of bias assessment according to the Cochrane guidelines, random-effects meta-analyses of odds ratios (OR) or mean differences (MD) and their 95% confidence intervals (CI) were performed, followed by meta-regression and sensitivity analyses. RESULTS A total of 27 nonrandomized studies with 1,572 patients (mean age 42.2 years/51.2% female) followed up to 18.5 years after implant placement were included. The pooled %prevalence of IIP was 50.5% (nine studies; 95% CI = 26.3-74.5%), and the pooled IIP extent was 0.58 mm (six studies; 95% CI = 0.33-0.83 mm), while IIP > 1 mm was seen for 20.8% of placed implants (five studies; 95% CI = 8.3-37.1%), and male patients were less prone to IIP than female patients (three studies; OR = 0.30; 95% CI = 0.10-0.88; p = 0.03). The pooled %prevalence of PCP loss was 46.3% (nine studies; 95% CI = 32.3-60.6%), with increase through observation time (two studies; OR = 1.09; 95% CI = 1.03-1.16; p = 0.004) and predilection for mesial PCPs (five studies; OR = 2.25; 95% CI = 1.06-4.77; p = 0.03). However, the quality of evidence was very low due to bias. CONCLUSIONS Patients and doctors need to be aware that long-term adverse effects of dental implants among natural teeth can be observed in terms of IIP and PCP loss to the adjacent teeth.