Platform‐switched implants vs platform‐matched implants placed in different implant‐abutment interface positions: A prospective randomized clinical and microbiological study

Abstract

Background Placement of the implant‐abutment interface (IAI) away from the bone crest has been suggested to have positive impacts on maintenance of peri‐implant tissues. Purpose To assess the effects of platform‐switched and platform‐matched implants, taking into consideration the IAI at different positions relative to the bone crest, on clinical, radiographic, and microbiological outcomes during 12 months following functional loading. Materials and Methods The present prospective randomized study was performed upon 70 patients. Group I (n = 23) implants presenting a platform‐switched implant‐abutment connection design was inserted 1 mm subcrestally. Group II (n = 22) implants with similar properties were inserted crestally. Group III (n = 25) implants presenting a platform‐matched approach with an internal hexagon connection design was inserted crestally. The periodontal parameters were assessed at baseline, and 3, 6, and 12 months postloading. Radiographic marginal bone level (MBL) changes were analyzed at the 12‐month follow‐up. The amount of DNA copies of Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitans, Tannerella forsythia, Provetalla intermedia and total bacterial mean load in peri‐implant sulcus fluid (PISF) were assessed at the same periods. Results There were no significant differences among the groups with respect to the periodontal parameters for all time periods. At 12‐month follow‐up, the MBL changes were 0.16 ± 0.29 mm and 0.17 ± 0.23 mm for group I, 0.15 ± 0.25 mm and 0.17 ± 0.26 mm for group II, 0.17 ± 0.26 mm and for group III in mesial and distal sites, respectively. The mean total bacterial load was found significantly higher for group III compared to the other groups in the three interval times (P < .05). Conclusion Implants restored with platform‐switching and platform‐matching performed equally regarding clinical and radiographic outcomes. Platform‐matched implants inserted at the crestal level presented higher the mean bacterial total load in PISF.

Using Cone-Beam Computed Tomography to Assess Changes in Alveolar Bone Width around Dental Implants at Native and Reconstructed Bone Sites: A Retrospective Cohort Study

“…Therefore, in this study, cases involving severe bone resorption and difficulties in distinguishing between the implant platform and the bone crest were excluded, and the alveolar bone width at 1 mm below the crest level was measured as the coronal third to reduce measurement errors. However, several studies have reported marginal bone loss around dental implants at the crest level [ 30 , 31 ]. Therefore, although the present study could accurately and clearly determine the alveolar bone width at the crest level, the resorption of coronal bone width around implants might be underestimated.…”

Comparative Study by Systematic Review and Meta-Analysis of the Peri-Implant Effect of Two Types of Platforms: Platform-Switching versus Conventional Platforms

“…The number of samples of implants with prosthetic platform change (PS) and without prosthetic platform change (PM) of the included studies was similar in all of them, the total implants samples being 475 and 462, respectively. The most disparate study in this regard had a sample size of 45 (PS)/25 (PM) [ 11 ]. All these data are shown in Table 1 .…”

“…Regarding the surgical procedure and flap design, Fernández et al [ 16 ] did not convey this information. Thus, of the remaining eight studies, all of them performed a full-thickness flap, which was subsequently closed in two studies until prosthetic restoration [ 11 ] or until an exposed healing abutment was added 8 weeks after surgery [ 15 ]. In the remaining six studies, the flap was sutured around an exposed healing abutment that modified the gingival profile of the implant until the time of prosthetic restoration.…”

“…With respect to whether the prosthetic restoration was screw retained or cemented, seven of the nine studies indicated that their restorations were cemented; Pozzi et al [ 15 ] indicated theirs were cement-screw retained with TempBond ® ; and Uraz et al [ 11 ] performed screw-retained restorations.…”

The effect of triangular cross‐section neck design on crestal bone stability in the anterior mandible: A randomized, controlled, split‐mouth clinical trial

“…Several studies demonstrated a favorable effect of PS, presenting crestal bone gains between 0.3 and 0.9 mm compared to platform-matching (Cappiello et al, 2008;Chrcanovic et al, 2015;Maeda et al, 2007;Telleman et al, 2014). According to the findings of Uraz et al (2020) and Lago et al (2017), PS implants inserted at the crestal level also presented low bacterial load and adequate soft tissue healing.…”