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An Improved Mechanical Testing Method to Assess Bone-implant Anchorage
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Radiographic Assessment Of Crestal Bone Loss In Tissue-Level Implants Restored By Platform Matching Compared With

Laura Lago, Luis da Silva, Isabel Martinez-Silva

    The International Journal of Oral & Maxillofacial Implants
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    This study found no significant difference in crestal bone level (CBL) changes between tissue-level implants with platform matching and bone-level implants with platform switching over three years. Both implant types demonstrated comparable long-term stability for dental prostheses.

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    Area of Science:

    • Dental Implantology
    • Periodontology
    • Biomaterials Science

    Background:

    • Dental implants are crucial for replacing missing teeth, with implant design influencing peri-implant bone health.
    • Crestal bone level (CBL) is a key indicator of implant success and longevity.
    • Platform matching and platform switching are two common prosthetic connection strategies with debated effects on bone levels.

    Purpose of the Study:

    • To compare radiologic changes in crestal bone level (CBL) between splinted tissue-level implants (platform matching) and bone-level implants (platform switching).
    • To evaluate the 3-year follow-up outcomes of these two implant types in patients requiring fixed dental prostheses.

    Main Methods:

    • A randomized, controlled, split-mouth trial involving 35 patients and 100 implants (50 tissue-level, 50 bone-level).
    • Periapical radiographs were used to assess peri-implant crestal bone changes at baseline, 1 year, and 3 years post-restoration.
    • Implants were categorized into control (tissue-level, platform matching) and test (bone-level, platform switching) groups.

    Main Results:

    • Crestal bone changes from baseline to 3 years were 0.18 ± 0.46 mm (P = .043) in the control group and 0.14 ± 0.35 mm (P = .514) in the test group.
    • No statistically significant differences in CBL were observed between the two groups at any time point (baseline to 1 year, 1 year to 3 years, or baseline to 3 years).
    • While the control group showed a statistically significant change from baseline to 3 years, the test group did not show significant changes over the study periods.

    Conclusions:

    • No statistically significant difference in crestal bone level changes exists between tissue-level implants with platform matching and bone-level implants with platform switching over a 3-year period.
    • Both implant designs appear to offer comparable long-term stability regarding peri-implant bone levels.
    • The findings suggest that prosthetic connection strategy may not be a critical factor in determining crestal bone maintenance in the long term.