Marginal bone loss around implants with platform switching and platform matched connection: A systematic review

Area of Science:

• Dental Implantology
• Periodontology
• Biomaterials Science

Background:

• Platform switching (PS) utilizes narrower abutments than the implant platform to mitigate marginal bone loss (MBL) around dental implants.
• While initial MBL reduction is noted, long-term evidence for PS efficacy remains limited, necessitating this systematic review.

Purpose of the Study:

• To systematically evaluate the long-term efficacy of platform switching (PS) versus platform matching (PM) implant abutment configurations.
• To determine if significant differences exist in marginal bone loss (MBL) around endosseous implants between PS and PM configurations.

Main Methods:

• A systematic literature search was conducted across PubMed/Medline, Scopus, Google Scholar, and Lilac databases (2000-2022).
• Included studies comprised human randomized clinical trials (RCTs) and potential clinically controlled cohort studies (PCCS) comparing PS and PM implants.
• Marginal bone loss (MBL) changes around endosseous implants were the primary outcome measure.

Main Results:

• Four eligible studies with 5-10 year follow-up periods were analyzed.
• Descriptive analysis of four RCTs indicated that platform-switched (PS) connections resulted in reduced average marginal bone loss (MBL) compared to platform-matched (PM) connections.
• Specific studies reported lower MBL for PS (e.g., 0.6 ±0.20 mm at 5 years) versus PM (e.g., 1.1 ±0.3 mm at 5 years), with differences ranging from 0.18 mm to 0.29 mm.

Conclusions:

• Platform switching (PS) demonstrates a beneficial effect in preserving crestal bone around dental implants.
• The PS technique appears to be a favorable approach for long-term MBL reduction compared to PM configurations.