Opening interproximal spaces between implants: why?

Last Updated January 07, 2016

I place and restore a lot of implants in my practice. I am very conservative: I rarely do immediate loading, everything is screw-retained, I use guided surgery and cone beam x-rays for almost every case. I wait 3 months to load the mandible and 6 months on the maxilla in most cases. I use mostly Nobel Conical Connect implants. I have noticed over the years that when I have two or more implants next to each other, the final restorations are perfect at the time of delivery (contacts are firm and broad, very light occlusion, no excursive contacts, etc). But about a year later, I have noticed that a high percentage of these cases develop open contacts interproximally. Theoretically, that should not happen, but yet it happens in more than 40% of my cases where there are two or more adjacent implants. This never happens when it is a single implant next to natural dentition. Does anyone have any theories on why this is happening?

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