The mesial–mesial/distal–distal (MM-DD) occlusal adjustment technique: A 2–21.5-year retrospective study on preventing open contacts in posterior implant restorations

Abstract

Background/purpose

Open contacts adjacent to posterior dental implants are a common clinical complication, often resulting in food impaction, discomfort, and periodontal deterioration. This study aimed to evaluate the long-term clinical effectiveness of the mesial–mesial/distal–distal (MM-DD) occlusal adjustment technique in preventing open contacts adjacent to posterior implant restorations.

Materials and methods

This retrospective study analyzed 124 single-tooth posterior implants in 100 patients over a 2–21.5-year follow-up period. The MM-DD technique involved selectively modifying occlusal contacts on the mesial occlusal surface of the mesial adjacent tooth and the distal occlusal surface of the distal adjacent tooth to influence mesial tooth movement and maintain proximal contact with implant restorations. Clinical and radiographic data were assessed for contact integrity, food impaction, discomfort, bone levels, and other outcomes. A control group with conventional occlusal adjustment was included for comparison.

Results

The MM-DD group demonstrated a significantly lower incidence of open contacts (2.7 %) compared to the control group (46.7 %, P <0.001). Patients treated with the MM-DD technique reported reduced food impaction and lower discomfort scores, with less proximal bone loss around adjacent teeth. Kaplan–Meier analysis showed high rates of long-term contact stability in the MM-DD group, with 96.2 % of contacts remaining intact at 15 years.

Conclusion

With its straightforward application, sound biological foundation, and minimal need for specialized equipment, the MM-DD technique presents a practical and effective solution for preserving proximal contact in posterior implants and is well-suited for widespread adoption in daily dental practice.