Influence of platform switching on bone-level alterations: a three-year randomized clinical trial

Area of Science:

• Implant Dentistry
• Periodontology
• Biomaterials Science

Background:

• Platform switching is a technique in implant dentistry aiming to reduce peri-implant crestal bone loss.
• Existing clinical data on platform switching efficacy is controversial and often limited to shorter follow-up periods (12 months).

Purpose of the Study:

• To evaluate the long-term (3-year) impact of platform switching on peri-implant crestal bone-level changes.
• To test the hypothesis that platform switching offers a clinical advantage over standard implants regarding bone preservation.

Main Methods:

• A randomized clinical trial involving 25 patients with posterior mandibular implants.
• Intraindividual comparison of platform-switched (3.3-mm platform) and standard (4-mm platform) implants (4 mm diameter).
• Radiographic assessment of crestal bone levels at 3 years post-implantation using the Brunner-Langer statistical model.

Main Results:

• Mean radiographic peri-implant bone loss at 3 years was 0.69 ± 0.43 mm for platform switching and 0.74 ± 0.57 mm for standard platforms.
• No statistically significant difference in crestal bone loss was observed between platform switching and standard implants (p = .363).
• Crestal bone levels showed a significant change over time (p < .001) but were not influenced by the platform type.

Conclusions:

• The hypothesis that platform switching reduces peri-implant crestal bone loss could not be confirmed in this 3-year randomized clinical trial.
• Platform switching did not demonstrate a significant benefit over standard implants for crestal bone preservation in the evaluated patient cohort.
• Further long-term studies are warranted to fully elucidate the role and efficacy of platform switching in implant dentistry.