Opening interproximal spaces between implants: why?

Agree with your observation. To my mind it happens mostly on the lower jaw opposite to natural antagonists because loading mastication vectors are not usually perpendicular to an implant long axis and shifting goes mostly medially.

Can you tell us if any of these cases also develop screw or abutment loosening? I don't find this in my cases. I am wondering if it has to do with some screw retained cases. Thanks for posting.

Integrated implants don't move they are anklylosed to the bone. Could this be a prosthetic issue? Could you post some films, initial placement and when the contacts open? Perhaps a clinical photo? X-rays can be deceiving. Implants don't shift unless they have failed not a gradual process like a tooth.

In thirty years of placing implants I have never seen this, please post some examples.

I agree with CRS........ implants that have osseointegrated, are ankylosed to the bone...they do not move........but if any spaces are opening between implant to implant, then it is probably a prosthetic screw that has become loose. When you look at the actual size of a prosthetic crown, and the diameter of the hex retaining screw, and I will throw it the internal hex of the implant as well......there is definately an engineering mismatch of the components, that has yet to be solved......... the torque ratio of the forces result in screw loosening ....if you are lucky, or screw fracturing.....which is also not so bad, or at the worst, the wall of the implant will fracture....and the implant will have to be removed. So while our terrific field of dentistry , implantology , has made enormous strides over a relatively short time.... we still have not caught up with nature......... so if you want to keep score.....God = 100% Man 65 % .......maybe if we throw Donald J. Trump into the equation.... he will possibly make Dental Implantology Great!!!

Seems that there is not stable occlusion to me. I stabilize most of my cases with 4 gold occlusals in the posterior. Not only porcelain and bone and stability of implants remains. Instead of priximal contacts make guide planes in the interproximal areas and then the proximal coutour of the teeth.

Hi - do you have any radiographs and photographs showing the changes over time? Thanks

It can be detected clinically with a mylar 0.3 mm. or metal 0.1 mm. thick strip separation test between crowns. X ray is not very helpful in it.

Whats the age of the patients when they had the implants placed in which you have noticed the changes? Is it a youger group or across the board?

Sometimes theory differs from practical results. Even "rigid" materials such as concrete, porcelain, metals have "flexural strength" property. As bones mostly consist of collagen tissue they have qualities of flexible and resilient material.

I have not seen the phenomenon of contacts between integrated implants with crowns opening up. However I have seen many contacts open between a natural tooth and an implant, this even when there is apparent integrity of contacts throughout the arch. This phenomenon has been reported in the literature to some extent and seems to be reported as occurring most often on the mesial side of the implant and usually in the mandible. The explanations are: that force vectors have changed, fluid hydrodynamics are to blame, micro food impaction issues develop which progressively increases the contact opening. There is no clear study which accounts for the reason. In these instances some form of revision will become necessary. If the crown is screw retained then the process becomes easier.