Double‐blind randomized controlled trial study on post‐extraction immediately restored implants using the switching platform concept: soft tissue response. Preliminary report

Purpose: To evaluate and compare peri-implant health, marginal bone loss and success of immediate and delayed implant placement for rehabilitation with full-arch fixed prostheses. Material and Methods: The present study was a prospective, randomized, single-blind, clinical preliminary trial. Patients were randomized into two treatment groups. In Group A implants were placed immediately post-extraction and in Group B six months after extraction. The following control time-points were established: one week, six months and twelve months after loading. Measurements were taken of peri-implant crevicular fluid volume, plaque index, gingival retraction, keratinized mucosa, probing depth, modified gingival index and presence of mucositis. Implant success rates were evaluated for the two groups. The study sample included fifteen patients (nine women and six men) with a mean average age of 63.7 years. One hundred and forty-four implants were placed: 76 placed in healed sites and 68 placed immediately. Results: At the moment of prosthetic loading, keratinized mucosa width and probing depth were higher in immediate implants than delayed implants, with statistically significant differences. However, after six and twelve months, differences between groups had disappeared. Bone loss was 0.54 ± 0.39 mm for immediate implants and 0.66 ± 0.25 mm for delayed implants (p=0.201). No implants failed in either group. Conclusions: The present study with a short follow-up and a small sample yielded no statistically significant differences in implant success and peri-implant marginal bone loss between immediate and delayed implants with fixed full-arch prostheses. Peri-implant health showed no statistically significant differences for any of the studied parameters (crevicular fluid volume, plaque index, gingival retraction, keratinized mucosa, probing depth, modified gingival index and presence of mucositis) at the twelve-month follow-up. Key words:Immediate implants, delayed implants, peri-implant health, success rate.

Section: Discussionsupporting

confidence: 92%

Single-blind randomized clinical trial to evaluate clinical and radiological outcomes after one year of immediate versus delayed implant placement supporting full-arch prostheses

Pellicer-Chover

Peñarrocha‐Oltra²,

Bagán³

et al. 2014

“…Nevertheless, a similar study found no difference between platform switching and platform matching (on average from 7.71 to 7.51 –0.2mm- vs. 9 to 8.57 -0.4mm-) (26). …”

Section: Resultsmentioning

confidence: 98%

Immediate implants following tooth extraction. A systematic review

Ortega-Martínez¹,

Pérez-Pascual²,

Mareque³

et al. 2012

Objectives: The aim of this article is to review the current state of immediate implants, with their pros and contras, and the clinical indications and contraindications. Material and Methods: An exhaustive literature search has been carried out in the COCHRANE library and MEDLINE electronic databases from 2004 to November 2009. Randomized clinical trials and clinical trials focused on single implants placed in fresh extraction sockets were included and compared. A meta-analysis could not be performed due to heterogeneity of the data. Results: Twenty studies out of 135 articles from the initial search were finally included, which summed up a total of 1139 immediate implants with at least a 12-month follow-up. Our results have been compared with other current available papers in the literature reviewed that obtained similar outcomes. Discussion: Immediate implants have predictable results with several advantages over delayed implant placement. However, technical complications have been described regarding this technique. Also, biomaterials may be needed when the jumping distance is greater than 1mm or any bone defect is present. Conclusions: Few studies report on success rates rather than survival rates in the literature reviewed. Short-term clinical results were described and results were comparable to those obtained with delayed implant placement. Further long-term, randomized clinical trials are needed to give scientific evidence on the benefits of immediate implants over delayed implant placement. Key words:Immediate implants, fresh socket, dental implants, gap, jumping distance, implant stability.

“…Platform expansion in post-extraction situations makes it possible to minimize the gap between the recently extracted tooth bed and the implant, acting as a physical barrier against the penetration of bacteria in the zone of contact between the bone and implant. This increase in diameter favors improved primary stability (15,(28)(29)(30)(31).…”

Section: E404mentioning

confidence: 99%

The influence of platform switching in dental implants. A literature review

Serrano-Sánchez¹,

Calvo-Guirado²,

Manzanera-Pastor³

et al. 2011

Introduction: The platform switching concept involves the reduction of the restoration abutment diameter with respect to the diameter of the dental implant. In 1991, dental implants of 5 and 6 mm diameter platforms were introduced. However, matching-diameter prosthetic abutments were not available. These implants were restored with "standard"-diameter prosthetic components (4,1 mm). Long-term follow up around these wide-platforms showed higher levels of bone preservation. In time, it has been called platform switching. The first case report applying this concept was indexed in MedLine in 2005. Materials and Methods: The aim of this article is to carry out a literature review of articles which deal with the influence of this modified platform in hard and soft oral tissues. All papers involving "platform switching" that are indexed in MedLine and published in English were used. Clinical cases, experimental and non-experimental studies were included, as well as literature reviews. Results: In our search, we found: 16 clinical series or single clinical cases, 10 test and control studies, 9 experimental studies and 3 reviews. Conclusion: All papers written by different researchers show an improvement in perimplant bone preservation. Further long-term studies are necessary to confirm these results. The articles consulted refer to the biomechanical behavior of the abutment-implant complex in response to occlusal loading, the maintenance of crestal bone height and the peculiar repositioning of the biological space.