Value of platform switching on marginal peri-implant bone loss reduction : A summary review

Abstract

Summary Question:Is there an impact of platform switching (PS) on marginal bone level changes MBL around endosseous implants compared to implants with platform-matching (PM) implant-abutment confi gurations? Data Sources: PubMed, Web of Science, Journals at Ovid Full Text and Embase published between 2005 and June 2013. Besides manual search in the peer reviewed Germanlanguage Journal of Oral Implantology (Zeitschrift fur zahnarztliche Implantologie) or Implantologie (for both journals RCTs and PCCS were included). Study Selection: Articles that published between 2005 and 2013 that reporting comparison of MBL changes at implants with PS or PM implant-abutment confi gurations as primary outcome were selected from electronic databases with language restriction was for English or German. RCTs with a follow-up period of at least 12 months were included in the meta-analysis. Data Extraction and Synthesis: Data were extracted by 2 reviewers independently with high agreement between them. A search strategy was conducted using the MeSH and search term combinations, considering the PICO format. Th e quality assessment of RCTs is performed following the recommendations by Higgins and Green (2011). Th e diff erence of the assessment results was low, resulting in a κ score of 0.923 (disagreement in four of 105 fi elds) between the reviewers. Consent was reached by discussion. Results: Regarding PCCS the total articles were 7 that were interpretate separately because of lacking of random allocation that revealing 3 studies with no signifi cance between two group whereas 3 studies reveal signifi cance diff erence between two group preferring PS (less MBL) and one study reveal a remarkable mean MBL in the PM group compared to the PS group. Whereas searching for RCTS resulting in a total of 13 that are eligible for inclusion into a meta-analysis that comprised a total of 549 patients receiving 1035 implants. Because of signifi cant degree of heterogeneity (I 2 = 96.2%) P < 0.0001 the treatment eff ects were assumed to be not homogeneous among the studies, and a random eff ects model for combining eff ects of all studies was applied. Th e meta-analysis result was reveal a signifi cantly less mean MBL change (0.49 mm CI95% [0.38; 0.60]) at PS implants compared to PM implants (1.01 mm (CI95% 0.62; 1.40) [P < 0.0001]) on an implantbased analysis. Funnel-plot calculation showed no asymmetry (P = 0.733), and therefore, no publication bias. Conclusion: Only two studies with a low risk of bias. All other studies revealed a tendency of a high risk of bias, resulting in an overall unclear and high risk of bias across studies. So, the author recommend for further research to overcome all these previous limitations and for providing more evidence research on the eff ect of PS on MBL.