Platform-switching implants and bone preservation: a systematic review and meta-analysis

Area of Science:

• Dental Implantology
• Biomaterials Science
• Oral Surgery

Background:

• Dental implant stability and longevity are crucial for successful oral rehabilitation.
• Marginal bone loss around implants is a key indicator of implant health and long-term success.
• Platform-switching (PSW) is a design modification in dental implants aimed at potentially improving bone preservation.

Purpose of the Study:

• To conduct a systematic review and meta-analysis comparing platform-switching (PSW) implants with regular platform (RP) implants.
• To evaluate the efficacy of PSW implants regarding bone preservation and implant longevity.
• To assess the relative risk of implant failure and mean difference in marginal bone loss between PSW and RP implants.

Main Methods:

• Systematic review and meta-analysis adhering to PRISMA, PICO, and Jadad scale guidelines.
• Inclusion of 25 studies (17 RCTs, 8 prospective studies) with 1098 patients and 2310 implants.
• Calculation of relative risk (RR) for failure and mean difference for marginal bone loss with 95% confidence intervals (CI).

Main Results:

• A statistically significant reduction in crestal bone loss was observed with PSW implants compared to RP implants (-0.41mm, 95% CI -0.52 to -0.29, P<0.00001).
• No significant difference in implant failure rates was found between PSW and RP implants (RR 1.10, 95% CI 0.6-2.02, P=0.75).
• Subgroup analyses indicated reduced bone loss with PSW implants in RCTs, and for implants placed in both the maxilla and mandible.

Conclusions:

• Platform-switching implants demonstrate a benefit in preserving marginal bone levels compared to regular platform implants.
• The longevity and survival rates of PSW and RP implants are comparable based on current evidence.
• Further randomized controlled trials are recommended to elucidate potential biases and confirm findings.