Impact of platform switching on marginal peri‐implant bone‐level changes. A systematic review and meta‐analysis

Abstract

ObjectiveTo address the focused question, is there an impact of platform switching (PS) on marginal bone level (MBL) changes around endosseous implants compared to implants with platform matching (PM) implant-abutment configurations?Material and methodsA systematic literature search was conducted using electronic databases PubMed, Web of Science, Journals@Ovid Full Text and Embase, manual search for human randomized clinical trials (RCTs) and prospective clinical controlled cohort studies (PCCS) reporting on MBL changes at implants with PS-, compared with PM-implant-abutment connections, published between 2005 and June 2013.ResultsTwenty-two publications were eligible for the systematic review. The qualitative analysis of 15 RCTs and seven PCCS revealed more studies (13 RCTs and three PCCS) showing a significantly less mean marginal bone loss around implants with PS- compared to PM-implant-abutment connections, indicating a clear tendency favoring the PS technique. A meta-analysis including 13 RCTs revealed a significantly less mean MBL change (0.49 mm [CI95% 0.38; 0.60]) at PS implants, compared with PM implants (1.01 mm [CI95% 0.62; 1.40] (P < 0.0001).ConclusionsThe meta-analysis revealed a significantly less mean MBL change at implants with a PS compared to PM-implant-abutment configuration. Studies included herein showed an unclear as well as high risk of bias mostly, and relatively short follow-up periods. The qualitative analysis revealed a tendency favoring the PS technique to prevent or minimize peri-implant marginal bone loss compared with PM technique. Due to heterogeneity of the included studies, their results require cautious interpretation.

Platform switching of implants may decrease bone loss

“…One reached a similar conclusion to this meta-analysis in that the greater the mismatch between the implant platform and the abutment, the greater the bone preservation, 8 while the other suggested that there was significantly less MBL with a platform-switched implant as compared to a platform-matched implant. 9 These two studies corroborate the results from this systematic review and meta-analysis and also inform the reader that we are still awaiting longer-term clinical investigations whereby more definitive conclusions as to the theorised benefits of platform-switching may be drawn.…”

Influence of Laser‐Microtextured Surface Collar on Marginal Bone Loss and Peri‐Implant Soft Tissue Response: A Systematic Review and Meta‐Analysis

“…However, details of the retention type were frequently not present, which cannot eliminate the influence of cement 54 on MBL and PD as possible etiology. In addition, implant‐abutment connection type is also an important factor in MBL 55 , 56 . Nevertheless, these data were not sufficiently clear in some of the included studies.…”

Influence of Soft Tissue Thickness on Peri‐Implant Marginal Bone Loss: A Systematic Review and Meta‐Analysis

“…The influence of PS abutment designs on MBL has been widely investigated; however, the results are controversial, 20 , 39 , 40 and no clear conclusion could be drawn at this point. Although clinical studies and systematic reviews have reported potential beneficial effects, 17 , 20 , 39 multiple studies failed to demonstrate any significant difference if thin mucosa (<2 mm) is present 22 , 41 . Accordingly, Vandeweghe and DeBruyn concluded that PS is effective only when mucosal thickness is enough for establishment of BW 42 .…”

“…Accordingly, the concept of PS has been widely studied during the last decade and shows promising results 17–19 . Multiple randomized controlled trials as well as systematic reviews have confirmed its efficacy in maintaining crestal bone 17 , 20 , 21 …”