Norbert Enkling1, Peter Jöhren1, Victoria Klimberg1, Stefan Bayer1, Regina Mericske-Stern1, Søren Jepsen1. 1. Department of Prosthodontics, University of Berne, Berne, SwitzerlandDepartment of Oral Surgery, University of Witten/Herdecke, Witten, GermanyDepartment of Prosthetic Dentistry, Propaedeutics and Material Science, University of Bonn, Bonn, GermanyDepartment of Periodontology, Operative and Preventive Dentistry, University of Bonn, Bonn, Germany.
Abstract
OBJECTIVE: The concept of platform switching has been introduced to implant dentistry based on observations of reduced peri-implant bone loss. However, randomized clinical trials are still lacking. This study aimed to test the hypothesis that platform switching has a positive impact on crestal bone-level changes. MATERIAL AND METHODS: Two implants with diameters of 4 mm were inserted epicrestally into one side of the posterior mandibles of 25 subjects. After 3 months of submerged healing, the reentry surgery was performed. On the randomly placed test implant, an abutment 3.3 mm in diameter was mounted, resulting in a horizontal circular step of 0.35 mm (platform switching). The control implant was straight, with an abutment 4 mm in diameter. Single-tooth crowns were cemented provisionally. All patients were monitored at short intervals over the course of 1 year. Standardized radiographs and microbiological samples from the implants' inner spaces were obtained at baseline (implant surgery), and after 3, 4, and 12 months. RESULTS: After 1 year, the mean radiographic vertical bone loss at the test implants was 0.53±0.35 mm and at the control implants, it was 0.58±0.55 mm. The mean intraindividual difference was 0.05±0.56 mm, which is significantly <0.35 mm (P=0.0093, post hoc power 79.9%). The crestal bone-level changes depended on time (P<0.001), but not on platform switching (P=0.4). The implants' internal spaces were contaminated by bacteria, with no significant differences in the total counts between the test and the control at any time point (P=0.98). CONCLUSIONS: The present randomized clinical trial could not confirm the hypothesis of a reduced peri-implant bone loss at implants restored according to the concept of platform switching.
RCT Entities:
OBJECTIVE: The concept of platform switching has been introduced to implant dentistry based on observations of reduced peri-implant bone loss. However, randomized clinical trials are still lacking. This study aimed to test the hypothesis that platform switching has a positive impact on crestal bone-level changes. MATERIAL AND METHODS: Two implants with diameters of 4 mm were inserted epicrestally into one side of the posterior mandibles of 25 subjects. After 3 months of submerged healing, the reentry surgery was performed. On the randomly placed test implant, an abutment 3.3 mm in diameter was mounted, resulting in a horizontal circular step of 0.35 mm (platform switching). The control implant was straight, with an abutment 4 mm in diameter. Single-tooth crowns were cemented provisionally. All patients were monitored at short intervals over the course of 1 year. Standardized radiographs and microbiological samples from the implants' inner spaces were obtained at baseline (implant surgery), and after 3, 4, and 12 months. RESULTS: After 1 year, the mean radiographic vertical bone loss at the test implants was 0.53±0.35 mm and at the control implants, it was 0.58±0.55 mm. The mean intraindividual difference was 0.05±0.56 mm, which is significantly <0.35 mm (P=0.0093, post hoc power 79.9%). The crestal bone-level changes depended on time (P<0.001), but not on platform switching (P=0.4). The implants' internal spaces were contaminated by bacteria, with no significant differences in the total counts between the test and the control at any time point (P=0.98). CONCLUSIONS: The present randomized clinical trial could not confirm the hypothesis of a reduced peri-implant bone loss at implants restored according to the concept of platform switching.
Authors: N Enkling; P Jöhren; J Katsoulis; S Bayer; P-M Jervøe-Storm; R Mericske-Stern; S Jepsen Journal: J Dent Res Date: 2013-10-24 Impact factor: 6.116
Authors: Yun-Chi Wang; Joseph Y K Kan; Kitichai Rungcharassaeng; Phillip Roe; Jaime L Lozada Journal: Clin Oral Implants Res Date: 2014-01-03 Impact factor: 5.977