Two-Center Observational Case Series Describing Decay Adjacent to Fixed Implant Restorations (DATFIR) and Evaluation of Case Parameters

(Pages: 32-41)

David French1, Marie-Catherine French2, Bernie Linke3 and Joseph Lizotte4

1Calgary AB T3A 0E2 and Part Time Faculty The University of British Columbia, 2199 Wesbrook Mall, Vancouver, BC V6T 1Z3; 2University of Alberta, Edmonton AB, Canada; 3Dept. of Prosthodontics, School of Dentistry, (ECHA), University of Alberta, Edmonton, AB, Canada; 4Edmonton AB, Canada


Aim: To describe Decay Adjacent to Fixed Implant Restoration in a retrospective case series and evaluate patterns of case parameters associated with this complication.

Materials and Methods: This observational study collected and described 56 cases of proximal tooth decay adjacent to fixed implant restoration (termed DATFIR) from a convenience sample of implants placed and followed at two referral based surgical centers, restorations were done by a general dental practices in referral area. The following parameters were evaluated; time in service, patient age and sex as well as site related parameters such as implant location in jaw, decay at mesial or distal of implant, interproximal contact loss, presence of a prior restoration on tooth that developed decay, and faulty margin on implant restoration.

Results: There were 56 sites of DATFIR in 46 patients. The time from implant placement to the time that decay was observed was on average 4.1 years. Teeth mesial to implant were more often involved with 44 mesial sites with DATFIR versus 12 distal sites. Posterior sites of DATFIR greatly outnumbered anterior sites at 55:1. The following “other parameters” were also evaluated. There were 13 sites where DATFIR developed in the presence of an open contact (ICL) and these were all sites where decay developed on the tooth mesial to the implant. There were 17 sites where DATFIR developed as recurrent decay on teeth with a prior restoration. There were 5 sites where DATFIR developed and there was an open margin noted on the implant crown.

Conclusion: DATFIR complication was observed most often on posterior teeth 3 to 5 years following implant placement and typically at the tooth mesial to the implant. The DATFIR complication also occurred often at sites of a previously restored tooth, sites of ICL, and open margins on implant restoration. A discussion between patient and clinician about this complication should be included as part of pre-operative informed consent and patients may also warrant more caries prevention strategies and closer follow up in certain cases.

Keywords: Dental implant, complications, decay, contact loss, food trap, case series.