Influence of Platform Switching on Bone-level Alterations

Abstract

The concept of platform switching has been introduced to implant dentistry based on clinical observations of reduced peri-implant crestal bone loss. However, published data are controversial, and most studies are limited to 12 months. The aim of the present randomized clinical trial was to test the hypothesis that platform switching has a positive impact on crestal bone-level changes after 3 years. Two implants with a diameter of 4 mm were inserted crestally in the posterior mandible of 25 patients. The intraindividual allocation of platform switching (3.3-mm platform) and the standard implant (4-mm platform) was randomized. After 3 months of submerged healing, single-tooth crowns were cemented. Patients were followed up at short intervals for monitoring of healing and oral hygiene. Statistical analysis for the influence of time and platform type on bone levels employed the Brunner-Langer model. At 3 years, the mean radiographic peri-implant bone loss was 0.69 ± 0.43 mm (platform switching) and 0.74 ± 0.57 mm (standard platform). The mean intraindividual difference was 0.05 ± 0.58 mm (95% confidence interval: -0.19, 0.29). Crestal bone-level alteration depended on time (p < .001) but not on platform type (p = .363). The present randomized clinical trial could not confirm the hypothesis of a reduced peri-implant crestal bone loss, when implants had been restored according to the concept of platform switching.

Effect of Platform Shift/Switch on Crestal Bone Levels and Mucosal Profile Following Flapless Surgery and Crestal/Subcrestal Implant Placement

“…Due to heterogeneity of the included studies, their results require cautious interpretation.” A mean difference of approximately 0.5 mm in radiographic crestal height between technologies was observed. In perspective, recent prospective randomized clinical trials also using radiographic recordings largely reflecting the lingual (mesial/distal) aspect of the peri‐implant alveolar crest suggest limited, if any, benefits using platform shift/switch strategies . The present preclinical study provides a histologic record of buccal/lingual peri‐implant crestal remodeling and mucosal profile comparing platform shift/switch and standard abutments following flapless implant surgery using a dog model.…”

Impact of platform switching on inter‐proximal bone levels around 8.5 mm implants in the posterior region; 5‐year results from a randomized clinical trial

“…Enkling et al. (, ) showed in a 1‐ and 3‐years RCT that crestal bone alteration around standard‐length implants did not depend on platform switching. Two studies even favoured platform‐matched over platform‐switched implants, being a prospective 2‐years study of Crespi et al.…”

Investigational Clinical Research in Implant Dentistry

“…The randomized controlled trials have addressed important questions on patient-centered outcomes (Hamdan et al, 2013), the effect of immediate load on biological markers (Prati et al, 2013), and the influence of abutment-implant connections on crestal bone changes (Enkling et al, 2013). Cost-effectiveness in implant-supported single-tooth restoration versus tooth-supported fixed dental prosthesis was evaluated in a case-control study (Zitzmann et al, 2013).…”