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Platform switch – to be or not to be?
Andrija Petar BošnjakSchool of Dental Medicine, Zagreb, Croatia
Andrej MenigaPrivate practice, Zagreb, Croatia
Ann Wennerberg, Victoria FröjdSchool of Dentistry, Göteborg, Sweden
BackgroundBone resorption to the first thread
during initial loadingBiologic width around implants
(Berglundh & Lindhe 1996)
No resorption when an abutment with a narrower diamater is connected to the implant (Gardner 2005) – so called platform-switching
ObjectiveEvaluation of the difference in
histological findings between a platform-switching implant-to-abutment interface using a tight seal and a flat-to-flat interface
Differences in ISQ values during 3 months for implants with transmucosal healing (one-stage procedure)
Material and methods26 consecutive patients treated with 43
Ospol study implants4.0 diameter, implant length of 10, 12
and 15 mm supporting single crowns or fixed partial dentures
36 implants (83.7%) – single tooth replacements in lateral parts of mandible (58.8%) and maxilla (41.2%)
Material and methodsPaired implants
One with a healing abutment – creating
flat-to-flat interface
One with a standard abutment – creating platform switch interface
Material and methods
2×2 mm biopsy of soft tissue was acquired 3 months after implant placement for histological evaluation (at the time of crown/fixed partial denture fixation)
Immersed in sodium-cacodylate solution and subsequently analyzed
Material and methodsRadiographic assessment of marginal
bone levelAt the time of implant placementAt 3 months recall (time of crown fixation)
All patients were recalled monthly during osseointegration process
ISQ measurements at the time of surgery and 3 months postoperatively
ResultsCross-sections of fixated samples
Inflammatory cell inflitrateThickness of the epitheliumThickness of the connective tissue
Platform switch
No substantial number of inflammatory cells
Epithelial thickness
Well-defined “rete pegs”
Connective tissue layer
Flat-to-flat
No substantial inflammatory cell infiltrate
Epithelial thickness
Connective tissue layer
ISQ measurements
Platform-switch(± SD)
Flat-to-flat(± SD) p
At implant placement 72.5 ± 6.3 71.8 ± 5.9 NS
At 1 month 77.3 ± 4.2 77.1 ± 3.8 NS
At 3 months 81.8 ± 5.5 80 ± 4.7 NS
ConclusionHistologic analysis is in the early stage, but
there is no significant inflammatory cell infiltrate
Platform-switch seems to be as reliable for one-stage procedures as flat-to-flat interface
ISQ measurements confirm that the stability was maintained during initial three months of healing
Acknowledgments
Ospol, Malmö, SwedenGöran Urde & Hans Berglund @ Ospol, Malmö, SwedenPetra Hammarström Johansson @ Dept
Biomaterials/Handicap Research, Göteborg, SwedenMartina Vlah, Gordana Sporis & Lana Vodopija @
Meniga & Bosnjak LLC, Zagreb, CroatiaKresimir Sankovic, School of Pharmacy, Zagreb,
CroatiaDrazen Jovicevic, Dental Laboratory, Zagreb, Croatia
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