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Quintessence Publishing: Journals: EJOI

 

European Journal of Oral Implantology

Editor in Chief: Dr. Marco Esposito

Official publication of the British Society of Oral Implantology (BSOI), Italian Society of Oral Surgery and Implantology (SICOI), Danish Society for Oral Implantology (DSOI), German Association of Oral Implantology (DGI), Spanish Society of Implantology (SEI), British Academy of Implant & Restorative Dentistry (BAIRD) and Advanced Dental Implant Research & Education Center (AIC)

ISSN (print) 1756-2406 • ISSN (online) 1756-2414

Publication:

Fall 2012
Volume 5 , Issue 3

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A within-implant comparison to evaluate the concept of platform switching. A randomised controlled trial

Vandeweghe, Stefan / De Bruyn, Hugo

Pages: 253 - 262

Purpose: To evaluate whether platform switching could preserve marginal bone around implants up to 6 months after loading.
Materials and methods: 15 patients were selected for a randomised controlled trial. Each patient received one customised wide body implant, with the external hex connection located eccentrically, allowing an extra 1 mm switch on one side. The hex was positioned at random at the mesial or distal side and the implant was loaded after 6 months of non-submerged healing. Patients were examined at 3, 6 and 12 months after surgery, during which a radiograph was taken to evaluate bone levels. At 12 months, the mucosal thickness was measured using a perio-probe.
Results: All implants survived and the mean overall bone loss, calculated from both the switched and non-switched side, was 0.39 mm (SD 0.33, range 0.00-1.45), 0.85 mm (SD 0.59, range 0.10-2.50) and 0.80 mm (SD 0.46, 0.26-1.89) after 3, 6 and 12 months, respectively. The bone loss continued up to 6 months but stabilised thereafter (P = 0.615). Significantly more bone loss was observed at the non-switched side compared to the switched side at 3 months (0.51 mm versus 0.28 mm, P = 0.019), 6 months (1.05 mm versus 0.64 mm, P = 0.002) and 12 months (0.94 mm versus 0.66 mm, P = 0.002). The mean mucosal thickness was 4.22 mm (SD 1.45; range 1.50-7.00), and was not significantly different between the switched and non-switched sides (P = 0.882). However, using a post-hoc analysis with the mean thickness as a threshold, the mean bone loss was only significantly different between switched and non-switched sides when the mucosa was thicker than 4.22 mm (P = 0.036).
Conclusions: The outcome of this randomised trial is in accordance with earlier studies suggesting that that platform switching decreases bone loss by 30%. Although the sample size was limited, it seems that the creation of a biologic width affects peri-implant bone loss to a significant extent and that platform switching is only effective when the mucosal thickness allows the establishment of a biologic width.

Keywords: bone loss, implant, platform switching, southern implants, wide body

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