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The Platform Swithching Concept

Year 2013, Volume: 16 Issue: 3, 235 - 241, 26.07.2013

Orhun Ekren Ahmet Ozkomur

https://doi.org/10.7126/cdj.2013.856

Abstract

The success of the dental implants mostly depends on the health of hard and soft tissues. One of the most important reason of dental implant failure is the crestal bone resorption around implants. It is generally accepted that marginal bone loss is about 1-1.5 mm in the first year after functional loading and 0.1 mm in subsequent years annually. 

            The resorption of the marginal bone effects the success of the dental implants in functional loading, aesthetics and if the resorption is accompanied with gingival recession it also effects the hygien control negatively.

            Platform switching is a definition refers the reduction of the abutment diameter with respect to diameter of the dental implant. The concept rised by the use of 4 mm standart implant abutments over 5 mm and 6 mm implants. Long term follow up of these wide platform-small abutment combinations showed higher levels of bone preservation which encouraged the manufacturers to change their design in order to adapt this concept.

            The aim of this review is to explain the logic and the principles of the platform switching concept.

Keywords

Platform switching marginal bone dental implant.

References

  • Adell R, Lekholm U, Rockler B, Branemark PI. A 15-year study of osseointegrated implants in the treatment of the edentulous jaw. Int J Oral Surg 1981;10:387-416.
  • Smith DE, Zarb GA. Criteria for success of osseointegrated endosseous implants. J Prosthet Dent 1989;62(5):567-572.
  • Misch CE. Implant success or failure: clinical assessment. In: Misch CE. Contemporary Implant Dentistry. St Louis: Mosby, 1993:29
  • Lazzara RJ, Porter SS. Platform switching: a new concept in implant dentistry for controlling postrestorative crestal bone levels. Int J Periodontics Restorative Dent Misch CE. Stres factors:influence on treatment planning. In:misch CE. Dental Implant Prosthetics, 1 st ed, Mosby, St.Louis Missouri, 2005:718
  • Leonhardt A, Berglundh T, Ericsson I, Dahlen G. Putative periodontal pathogens on titanium implants and teeth in experimental gingivitis and periodontitis in beagl dogs. Clin Oral Implants Res 1992;3:112-119.
  • Glauser R, Schüpbach P, Gottlow J, Hämmerle CH. Periimplant soft tissue barrier at experimental onepiece mini-implants with different surface topography in humans: A light-microscopic overview and histometric analysis. Clin Implant Dent Relat Res 2005;7 Suppl 1:S445
  • Sarment DP, Meraw SJ. Biological space adaptation to implant dimensions.Int J Oral Maxillofac Implants. 2008;23(1):99-104.
  • Weiner S, Simon J, Ehrenberg DS, Zweig B, Ricci JL. The effects of laser microtextured collars upon crestal bone levels of dental implants. Implant Dent 2008;17(2):217-220.
  • Luongo R, Traini T, Guidone PC, Bianco G, Cocchetto R, Celletti R. Hard and soft tissue responses to the platform-switching technique. Int J Periodontics Restorative Dent 2008;28(6):551-557.
  • Degidi M, Iezzi G, Scarano A, Piattelli A. Immediately loaded titanium implant with a tissuestabilizing/maintaining design ('beyond platform switch') retrieved from man after 4 weeks: a histological and histomorphometrical evaluation. A case report. Clin Oral Implants Res 2008;19(3):276-282.
  • Vela-Nebot X, Rodríguez-Ciurana X, Rodado-Alonso C, Segalà-Torres M. Benefits of an implant platform modification technique to reduce crestal bone resorption. Implant Dent 2006;15(3):313-320.
  • Canullo L, Rasperini G. Preservation of peri-implant soft and hard tissues using platform switching of implants placed in immediate extraction sockets: a proof-of-concept study with 12- to 36-month follow-up. Int J Oral Maxillofac Implants 2007;22(6):995-1000.
  • Prosper L, Redaelli S, Pasi M, Zarone F, Radaelli G, Gherlone EF. A randomized prospective multicenter trial evaluating the platform-switching technique for the prevention of postrestorative crestal bone loss. Int J Oral Maxillofac Implants 2009;24(2):299-308.
  • Jung RE, Jones AA, Higginbottom FL, Wilson TG, Schoolfield J, Buser D, Hämmerle CH, Cochran DL. The influence of non-matching implant and abutment diameters on radiographic crestal bone levels in dogs. J Periodontol 2008;79(2):260270.
  • Cochran DL, Bosshardt DD, Grize L, Higginbottom FL, Jones AA, Jung RE, Wieland M, Dard M. Bone response to loaded implants with non-matching implant-abutment diameters in the canine mandible. J Periodontol 2009;80(4):609-617.
  • Hürzeler M, Fickl S, Zuhr O, Wachtel HC. Peri-implant bone level around implants with platformswitched abutments: preliminary data from a prospective study. J Oral Maxillofac Surg 2007;65(7 Suppl 1):33-39.
  • Canullo L, Iurlaro G, Iannello G. Double-blind randomized controlled trial study on post-extraction immediately restored implants using the switching platform concept: soft tissue response. Preliminary report. Clin Oral Implant Res 2009;20:4144
  • Becker J, Ferrari D, Herten M, Kirsch A, Schaer A, Schwarz F. Influence of platform switching on crestal bone changes at nonsubmerged titanium implants: a histomorphometrical study in dogs. J Clin Periodontol 2007;34(12):1089109
  • Danza M, Riccardo G, Carinci F. Bone platform switching: a retrospective study on the slope of reverse conical neck. Quintessence Int. 2010;41(1):35-40.
  • Carinci F, Brunelli G, Danza M. Platform switching and bone platform switching. J Oral Implantol 2009;35(5):245-250.
  • Coelho AL, Suzuki M, Dibart S, DA Silva N, Coelho PG. Cross-sectional analysis of the implant-abutment interface. J Oral Rehabil 2007;34(7):508-516.
  • Broggini N, McManus LM, Hermann JS, Medina R, Schenk RK, Buser D, Cochran DL. Peri-implant inflammation defined by the implantabutment interface. J Dent Res. 2006;85(5):473-478.
  • Broggini N, McManus LM, Hermann JS, Medina RU, Oates TW, Schenk RK, Buser D, Mellonig JT, Cochran DL. Persistent acute inflammation at the implant-abutment interface. Dent Res 2003;82(3):232-237.
  • Ericsson I, Persson LG, Berglundh T, Marinello CP, Lindhe J, Klinge B. Different types of inflammatory reactions in peri-implant soft tissues. J Clin Periodontol 1995;22(3):25526
  • Newman M, Takei H, Carranza F, The Norman Periodontium, In:Caranza’s Clinical Periodontology, 9 th ed, WB Sounders Co. USA 2002:p15-58.
  • Berglundh T, Lindhe J, Ericsson I, Marinello CP, Liljenberg B, Thomsen P. The soft tissue barrier at implants and teeth. Clin Oral Implants Res 1991;2(2):81-90.
  • Canullo L, Pellegrini G, Allievi C, Trombelli L, Annibali S, Dellavia C. Soft tissues around long-term platform switching implant restorations: a histological human evaluation. Preliminary results. J Clin Periodontol 201;38(1):86-94. Trammell K, Geurs NC, O'Neal SJ, Liu PR, Haigh SJ, McNeal S, Kenealy JN, Reddy MS. A prospective, randomized, controlled comparison of platform-switched and matched-abutment implants in shortspan partial denture situations. Int J Periodontics Restorative Dent 2009;29(6):599-605.
  • O’Brian WJ. Physical properties and Biocompatibility, In: Dental Materials and Their Selection, 3 rd Ed, İstanbul: Quintessence publishing Co, Inc., 2000:12-22.
  • Frost HM. Bone "mass" and the "mechanostat": a proposal. Anat Rec. Carter DR, Fyhrie DP, Whalen RT. Trabecular bone density and loading history: regulation of connective tissue biology by mechanical energy. J Biomech. 1987;20(8):785-794.
  • Cehreli M, Duyck J, De Cooman M, Puers R, Naert I. Implant design and interface force transfer. A photoelastic and strain-gauge analysis. Clin Oral Implants Res 2004;15(2):249-257.
  • Canay S, Hersek N, Akpinar I, Aşik Z. Comparison of stress distribution around vertical and angled implants with finite-element analysis. Quintessence Int 1996;27(9):59159
  • Hoshaw SJ, Brunski JB, Cochran GVB. Mechanical loading of branemark implants affects interfacial bone modeling and remodeling. Int J Oral Maxillofac Implants 1994;9:91-99.
  • Hansson S. The implant neck: smooth or provided with retention elements. A biomechanical approach. Clin Oral Implants Res 1999;10(5):394-405.
  • Hansson S. Implant-abutment interface: biomechanical study of flat top versus conical. Clin Implant Dent Relat Res 2000;2(1):33-41. Rangert B,Sullivan R, Biomechanical princibles,preventing overload induced by bending.Nobelpharma News 1993;7:4-5.
  • Sahin S, Cehreli MC, Yalçin E. The influence of functional forces on the biomechanics of implant-supported prostheses--a review. J Dent 2002;30(7-8):271-282.
  • Maeda Y, Satoh T, Sogo M. In vitro differences of stress concentrations for internal and external hex implantabutment connections: a short communication. J Oral Rehabil 2006;33(1):75-78.
  • Hansson S. A conical implantabutment interface at the level of the marginal bone improves the distribution of stresses in the supporting bone. An axisymmetric finite element analysis. Clin Oral Implants Res 2003;14(3):286-293.
  • Maeda Y, Miura J, Taki I, Sogo M. Biomechanical analysis on platform switching: is there any biomechanical rationale? Clin Oral Implants Res 2007;18(5):581-584.

Platform swithching yaklaşımı

Year 2013, Volume: 16 Issue: 3, 235 - 241, 26.07.2013

Orhun Ekren Ahmet Ozkomur

https://doi.org/10.7126/cdj.2013.856

Abstract

Kemik içi implantların kısa ve uzun vadedebaşarısı büyük oranda kemik ve yumuşak dokusağlığına bağlıdır. İmplant başarısızlığının enönemli sebeplerinden biri implant çevresi krestalkemik kaybı olarak gösterilir. Marjinal kemikkaybının en büyük oranda implantın fonksiyonagirdiği ilk yıl içinde gerçekleştiği, yaklaşık olarak1-1.5 mm kadar, sonraki yıllarda ise yıllık ortalama0.1 mm kadar olduğu genel olarak kabul edilmiştir.İmplant çevresindeki kemiğin rezorbe olmasıimplantın yükler karşısındaki başarısını, protezestetiğini ve kemik rezorpsiyonunu dişetiçekilmesinin de takip ettiği durumlarda hijyenkontrolünü negatif yönde etkiler. Bu gibiolumsuzluklardan dolayı implant üreticileri implantve üst yapı tasarımlarını marjinal kemik rezorpsiyonunu engelleyecek veya en aza indirecekşekilde modifiye etmişlerdir.Platform değişimi, (platform switching)implant çapının implant dayanağı çapından dahaküçük olduğu durumlar için kullanılan bir terimdir.Platform değişimi konsepti 5 ve 6 mm lik genişplatformlu implantların standart 4 mm implantlariçin yapılmış implant dayanakları ile birliktekullanılmasıyla ortaya çıkmıştır. Zaman içerisindegeniş implant ve daha küçük dayanak kullanılarakyapılan restorasyonlarda krestal kemik seviyelerinde daha başarılı sonuçlar görülmüş veimplant üreticileri implant dizaynlarını bu konsepteuyacak şekilde değiştirmeye başlamışlardır.Bu derleme çalışmasında platform değişimikonseptinin hangi mantık üzerine kurulduğu veprensipleri açıklanmaya çalışılmıştır.

Keywords

Platform değişimi marjinal kemik dental implant.

References

  • Adell R, Lekholm U, Rockler B, Branemark PI. A 15-year study of osseointegrated implants in the treatment of the edentulous jaw. Int J Oral Surg 1981;10:387-416.
  • Smith DE, Zarb GA. Criteria for success of osseointegrated endosseous implants. J Prosthet Dent 1989;62(5):567-572.
  • Misch CE. Implant success or failure: clinical assessment. In: Misch CE. Contemporary Implant Dentistry. St Louis: Mosby, 1993:29
  • Lazzara RJ, Porter SS. Platform switching: a new concept in implant dentistry for controlling postrestorative crestal bone levels. Int J Periodontics Restorative Dent Misch CE. Stres factors:influence on treatment planning. In:misch CE. Dental Implant Prosthetics, 1 st ed, Mosby, St.Louis Missouri, 2005:718
  • Leonhardt A, Berglundh T, Ericsson I, Dahlen G. Putative periodontal pathogens on titanium implants and teeth in experimental gingivitis and periodontitis in beagl dogs. Clin Oral Implants Res 1992;3:112-119.
  • Glauser R, Schüpbach P, Gottlow J, Hämmerle CH. Periimplant soft tissue barrier at experimental onepiece mini-implants with different surface topography in humans: A light-microscopic overview and histometric analysis. Clin Implant Dent Relat Res 2005;7 Suppl 1:S445
  • Sarment DP, Meraw SJ. Biological space adaptation to implant dimensions.Int J Oral Maxillofac Implants. 2008;23(1):99-104.
  • Weiner S, Simon J, Ehrenberg DS, Zweig B, Ricci JL. The effects of laser microtextured collars upon crestal bone levels of dental implants. Implant Dent 2008;17(2):217-220.
  • Luongo R, Traini T, Guidone PC, Bianco G, Cocchetto R, Celletti R. Hard and soft tissue responses to the platform-switching technique. Int J Periodontics Restorative Dent 2008;28(6):551-557.
  • Degidi M, Iezzi G, Scarano A, Piattelli A. Immediately loaded titanium implant with a tissuestabilizing/maintaining design ('beyond platform switch') retrieved from man after 4 weeks: a histological and histomorphometrical evaluation. A case report. Clin Oral Implants Res 2008;19(3):276-282.
  • Vela-Nebot X, Rodríguez-Ciurana X, Rodado-Alonso C, Segalà-Torres M. Benefits of an implant platform modification technique to reduce crestal bone resorption. Implant Dent 2006;15(3):313-320.
  • Canullo L, Rasperini G. Preservation of peri-implant soft and hard tissues using platform switching of implants placed in immediate extraction sockets: a proof-of-concept study with 12- to 36-month follow-up. Int J Oral Maxillofac Implants 2007;22(6):995-1000.
  • Prosper L, Redaelli S, Pasi M, Zarone F, Radaelli G, Gherlone EF. A randomized prospective multicenter trial evaluating the platform-switching technique for the prevention of postrestorative crestal bone loss. Int J Oral Maxillofac Implants 2009;24(2):299-308.
  • Jung RE, Jones AA, Higginbottom FL, Wilson TG, Schoolfield J, Buser D, Hämmerle CH, Cochran DL. The influence of non-matching implant and abutment diameters on radiographic crestal bone levels in dogs. J Periodontol 2008;79(2):260270.
  • Cochran DL, Bosshardt DD, Grize L, Higginbottom FL, Jones AA, Jung RE, Wieland M, Dard M. Bone response to loaded implants with non-matching implant-abutment diameters in the canine mandible. J Periodontol 2009;80(4):609-617.
  • Hürzeler M, Fickl S, Zuhr O, Wachtel HC. Peri-implant bone level around implants with platformswitched abutments: preliminary data from a prospective study. J Oral Maxillofac Surg 2007;65(7 Suppl 1):33-39.
  • Canullo L, Iurlaro G, Iannello G. Double-blind randomized controlled trial study on post-extraction immediately restored implants using the switching platform concept: soft tissue response. Preliminary report. Clin Oral Implant Res 2009;20:4144
  • Becker J, Ferrari D, Herten M, Kirsch A, Schaer A, Schwarz F. Influence of platform switching on crestal bone changes at nonsubmerged titanium implants: a histomorphometrical study in dogs. J Clin Periodontol 2007;34(12):1089109
  • Danza M, Riccardo G, Carinci F. Bone platform switching: a retrospective study on the slope of reverse conical neck. Quintessence Int. 2010;41(1):35-40.
  • Carinci F, Brunelli G, Danza M. Platform switching and bone platform switching. J Oral Implantol 2009;35(5):245-250.
  • Coelho AL, Suzuki M, Dibart S, DA Silva N, Coelho PG. Cross-sectional analysis of the implant-abutment interface. J Oral Rehabil 2007;34(7):508-516.
  • Broggini N, McManus LM, Hermann JS, Medina R, Schenk RK, Buser D, Cochran DL. Peri-implant inflammation defined by the implantabutment interface. J Dent Res. 2006;85(5):473-478.
  • Broggini N, McManus LM, Hermann JS, Medina RU, Oates TW, Schenk RK, Buser D, Mellonig JT, Cochran DL. Persistent acute inflammation at the implant-abutment interface. Dent Res 2003;82(3):232-237.
  • Ericsson I, Persson LG, Berglundh T, Marinello CP, Lindhe J, Klinge B. Different types of inflammatory reactions in peri-implant soft tissues. J Clin Periodontol 1995;22(3):25526
  • Newman M, Takei H, Carranza F, The Norman Periodontium, In:Caranza’s Clinical Periodontology, 9 th ed, WB Sounders Co. USA 2002:p15-58.
  • Berglundh T, Lindhe J, Ericsson I, Marinello CP, Liljenberg B, Thomsen P. The soft tissue barrier at implants and teeth. Clin Oral Implants Res 1991;2(2):81-90.
  • Canullo L, Pellegrini G, Allievi C, Trombelli L, Annibali S, Dellavia C. Soft tissues around long-term platform switching implant restorations: a histological human evaluation. Preliminary results. J Clin Periodontol 201;38(1):86-94. Trammell K, Geurs NC, O'Neal SJ, Liu PR, Haigh SJ, McNeal S, Kenealy JN, Reddy MS. A prospective, randomized, controlled comparison of platform-switched and matched-abutment implants in shortspan partial denture situations. Int J Periodontics Restorative Dent 2009;29(6):599-605.
  • O’Brian WJ. Physical properties and Biocompatibility, In: Dental Materials and Their Selection, 3 rd Ed, İstanbul: Quintessence publishing Co, Inc., 2000:12-22.
  • Frost HM. Bone "mass" and the "mechanostat": a proposal. Anat Rec. Carter DR, Fyhrie DP, Whalen RT. Trabecular bone density and loading history: regulation of connective tissue biology by mechanical energy. J Biomech. 1987;20(8):785-794.
  • Cehreli M, Duyck J, De Cooman M, Puers R, Naert I. Implant design and interface force transfer. A photoelastic and strain-gauge analysis. Clin Oral Implants Res 2004;15(2):249-257.
  • Canay S, Hersek N, Akpinar I, Aşik Z. Comparison of stress distribution around vertical and angled implants with finite-element analysis. Quintessence Int 1996;27(9):59159
  • Hoshaw SJ, Brunski JB, Cochran GVB. Mechanical loading of branemark implants affects interfacial bone modeling and remodeling. Int J Oral Maxillofac Implants 1994;9:91-99.
  • Hansson S. The implant neck: smooth or provided with retention elements. A biomechanical approach. Clin Oral Implants Res 1999;10(5):394-405.
  • Hansson S. Implant-abutment interface: biomechanical study of flat top versus conical. Clin Implant Dent Relat Res 2000;2(1):33-41. Rangert B,Sullivan R, Biomechanical princibles,preventing overload induced by bending.Nobelpharma News 1993;7:4-5.
  • Sahin S, Cehreli MC, Yalçin E. The influence of functional forces on the biomechanics of implant-supported prostheses--a review. J Dent 2002;30(7-8):271-282.
  • Maeda Y, Satoh T, Sogo M. In vitro differences of stress concentrations for internal and external hex implantabutment connections: a short communication. J Oral Rehabil 2006;33(1):75-78.
  • Hansson S. A conical implantabutment interface at the level of the marginal bone improves the distribution of stresses in the supporting bone. An axisymmetric finite element analysis. Clin Oral Implants Res 2003;14(3):286-293.
  • Maeda Y, Miura J, Taki I, Sogo M. Biomechanical analysis on platform switching: is there any biomechanical rationale? Clin Oral Implants Res 2007;18(5):581-584.
There are 38 citations in total.

Details

Primary Language Turkish
Journal Section Review
Authors

Orhun Ekren

Ahmet Ozkomur

Publication Date July 26, 2013
Submission Date May 7, 2011
Published in Issue Year 2013Volume: 16 Issue: 3

Cite

EndNote Ekren O, Ozkomur A (July 1, 2013) Platform swithching yaklaşımı. Cumhuriyet Dental Journal 16 3 235–241.

Cumhuriyet Dental Journal (Cumhuriyet Dent J, CDJ) is the official publication of Cumhuriyet University Faculty of Dentistry. CDJ is an international journal dedicated to the latest advancement of dentistry. The aim of this journal is to provide a platform for scientists and academicians all over the world to promote, share, and discuss various new issues and developments in different areas of dentistry. First issue of the Journal of Cumhuriyet University Faculty of Dentistry was published in 1998. In 2010, journal's name was changed as Cumhuriyet Dental Journal. Journal’s publication language is English.


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