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      Dental Implant Surrounding Marginal Bone Level Evaluation: Platform Switching versus Platform Matching—One-Year Retrospective Study

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          Abstract

          The benefits and feasibility of platform switching have been discussed in several studies, reporting lesser crestal bone loss in platform-switched implants than in platform-matched implants. Objective. The aim of the present study was to observe the changes in vertical and horizontal marginal bone levels in platform-switched and platform-matched dental implants. Materials and Methods. 51 patients received 60 dental implants in the present study over a 1-year period. Measurement was performed between the implant shoulder and the most apical and horizontal marginal defect by periapical radiographs to examine the changes of peri-implant alveolar bone before and 12 months after prosthodontic restoration delivery. Results. These marginal bone measurements showed a bone gain of 0.23 ± 0.58 mm in the vertical gap and 0.22 ± 0.53 mm in the horizontal gap of platform matching, while in platform switching a bone gain of 0.93 ± 1 mm ( P < 0.05) in the vertical gap and 0.50 ± 0.56 mm in the horizontal gap was found. The average vertical gap reduction from the baseline until 12 months was 0.92 ± 1.11 mm in platform switching and 0.29 ± 0.85 mm in platform matching ( P < 0.05). Conclusions. Within the limitations of the present study, platform switching seemed to be more effective for a better peri-implant alveolar bone vertical and horizontal gap reduction at 1 year.

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          Tissue integration of non-submerged implants. 1-year results of a prospective study with 100 ITI hollow-cylinder and hollow-screw implants.

          Ninian Lang, D Buser, H. Weber (1990)
          It has been postulated that the wound healing in a closed submerged location is one of the prerequisites for osseointegration of dental implants. The purpose of the present study was to evaluate the tissue integration of intentionally non-submerged titanium implants inserted by a one-stage surgical procedure. 100 ITI implants were consecutively placed in 70 partially edentulous patients. After a healing period free of masticatory loading for at least 3 months, the implants were examined. The clinical status showed for all implants neither detectable mobility nor signs of a peri-implant infection. Therefore, prosthetic abutments were inserted, and the patients were restored with fixed partial dentures. All patients were regularly recalled at 3-month intervals, and no patient dropped out of the study. Thus, all 100 implants were re-evaluated 12 months following implantation. Plaque- and sulcus bleeding indices, probing depth, clinical attachment level, width of keratinized mucosa, and periotest scores were assessed. In addition, standardized radiographs were analyzed for the presence of peri-implant radiolucencies and for the location of alveolar bone levels around the implants. Based on predefined criteria, the implants were classified as successful or failing. 98 implants were considered successful, and 1 implant failing. The remaining implant exhibited a peri-implant infection requiring local and systemic antimicrobial treatment. The results of this short-term study indicate that intentionally non-submerged ITI implants yield a high predictability for successful tissue integration.
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            Platform switching: a new concept in implant dentistry for controlling postrestorative crestal bone levels.

            R Lazzara, Stephanie Porter (2006)
            Histologic and radiographic observations suggest that a biologic dimension of hard and soft tissues exists around dental implants and extends apically from the implant-abutment interface. Radiographic evidence of the development of the biologic dimension can be demonstrated by the vertical repositioning of crestal bone and the subsequent soft tissue attachment to the implant that occurs when an implant is uncovered and exposed to the oral environment and matching-diameter restorative components are attached. Historically, two-piece dental implant systems have been restored with prosthetic components that locate the interface between the implant and the attached component element at the outer edge of the implant platform. In 1991, Implant Innovations introduced wide-diameter implants with matching wide-diameter platforms. When introduced, however, matching-diameter prosthetic components were not available, and many of the early 5.0- and 6.0-mm-wide implants received "standard"-diameter (4.1-mm) healing abutments and were restored with "standard"-diameter (4.1-mm) prosthetic components. Long-term radiographic follow-up of these "platform-switched" restored wide-diameter dental implants has demonstrated a smaller than expected vertical change in the crestal bone height around these implants than is typically observed around implants restored conventionally with prosthetic components of matching diameters. This radiographic observation suggests that the resulting postrestorative biologic process resulting in the loss of crestal bone height is altered when the outer edge of the implant-abutment interface is horizontally repositioned inwardly and away from the outer edge of the implant platform. This article introduces the concept of platform switching and provides a foundation for future development of the biologic understanding of the observed radiographic findings and clinical rationale for this technique.
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              Platform switching for marginal bone preservation around dental implants: a systematic review and meta-analysis.

              Ahmad Atieh, Momen Atieh, Mahmoud Ibrahim (2010)
              Platform switching for maintaining peri-implant bone levels has gained popularity among implant manufacturers over the last few years. However, the assumption that the inward shifting of the implant-abutment junction may preserve crestal bone was primarily based on serendipitous finding rather than scientific evidence. The objectives of the present study were to systematically review radiographic marginal bone-level changes and the survival of platform-switched implants compared to conventional platform-matched implants. A literature search of electronic databases (MEDLINE, EMBASE, The Cochrane Oral Health Group's Trials Register, The Cochrane Central Register of Controlled Trials, the U.K. National Research Register, the Australian New Zealand Clinical Trials Registry, the Database of Abstracts of Reviews of Effectiveness, and Conference Proceedings Citation Index) was performed up to March 15, 2010. Hand searches included several dental journals, and authors were contacted for missing information. Controlled trials that compared marginal bone-level changes around platform-switched dental implants with those restored with platform-matched prostheses were selected. The review and meta-analysis were done according to the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Data were analyzed using two meta-analytic statistical packages. Mean differences (MDs) were calculated for analyzing continuous data, and risk ratios (RRs) were used for dichotomous data with 95% confidence intervals (CIs). Ten studies with 1,239 implants were included. The marginal bone loss around platform-switched implants was significantly less than around platform-matched implants (MD: -0.37; 95% CI: -0.55 to -0.20; P or= 0.4 was associated with a more favorable bone response. The review and meta-analysis show that platform switching may preserve interimplant bone height and soft tissue levels. The degree of marginal bone resorption is inversely related to the extent of the implant-abutment mismatch. Further long-term, well-conducted, randomized controlled studies are needed to confirm the validity of this concept.
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                Author and article information

                Contributors
                May-Show Chen:
                ORCID: http://orcid.org/0000-0001-7236-1145
                Wei-Jen Chang:
                ORCID: http://orcid.org/0000-0002-6637-4430
                Journal
                Journal ID (nlm-ta): Biomed Res Int
                Journal ID (iso-abbrev): Biomed Res Int
                Journal ID (publisher-id): BMRI
                Title: BioMed Research International
                Publisher: Hindawi
                ISSN (Print): 2314-6133
                ISSN (Electronic): 2314-6141
                Publication date (Print): 2017
                Publication date (Electronic): 24 October 2017
                Volume: 2017
                Electronic Location Identifier: 7191534
                Affiliations
                1School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei 110, Taiwan
                2Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Boston, MA, USA
                3Dental Department, Taipei Medical University Hospital, Taipei 110, Taiwan
                4School of Oral Hygiene, College of Oral Medicine, Taipei Medical University, Taipei 110, Taiwan
                5Dental Department, Taipei Medical University, Shuang-Ho Hospital, Taipei 235, Taiwan
                Author notes

                Academic Editor: Hassan Maghaireh

                Author information
                http://orcid.org/0000-0003-4184-3744
                http://orcid.org/0000-0003-0361-7404
                http://orcid.org/0000-0001-6637-7044
                http://orcid.org/0000-0001-7236-1145
                http://orcid.org/0000-0002-6637-4430
                Article
                DOI: 10.1155/2017/7191534
                PMC ID: 5674488
                PubMed ID: 29204445
                SO-VID: ae8c1b23-ccd7-4977-9e53-b8e80fe4e83e
                Copyright © Copyright © 2017 Eisner Salamanca et al.
                License:

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 4 May 2017
                Date revision received : 21 August 2017
                Date accepted : 29 August 2017
                Categories
                Subject: Research Article

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