Impact of platform switching on marginal peri-implant bone-level changes. A systematic review and meta-analysis

Frank Peter Strietzel, Konrad Neumann, Moritz Hertel, Frank Peter Strietzel, Konrad Neumann, Moritz Hertel

Abstract

Objective: To address the focused question, is there an impact of platform switching (PS) on marginal bone level (MBL) changes around endosseous implants compared to implants with platform matching (PM) implant-abutment configurations?

Material and methods: A systematic literature search was conducted using electronic databases PubMed, Web of Science, Journals@Ovid Full Text and Embase, manual search for human randomized clinical trials (RCTs) and prospective clinical controlled cohort studies (PCCS) reporting on MBL changes at implants with PS-, compared with PM-implant-abutment connections, published between 2005 and June 2013.

Results: Twenty-two publications were eligible for the systematic review. The qualitative analysis of 15 RCTs and seven PCCS revealed more studies (13 RCTs and three PCCS) showing a significantly less mean marginal bone loss around implants with PS- compared to PM-implant-abutment connections, indicating a clear tendency favoring the PS technique. A meta-analysis including 13 RCTs revealed a significantly less mean MBL change (0.49 mm [CI95% 0.38; 0.60]) at PS implants, compared with PM implants (1.01 mm [CI95% 0.62; 1.40] (P < 0.0001).

Conclusions: The meta-analysis revealed a significantly less mean MBL change at implants with a PS compared to PM-implant-abutment configuration. Studies included herein showed an unclear as well as high risk of bias mostly, and relatively short follow-up periods. The qualitative analysis revealed a tendency favoring the PS technique to prevent or minimize peri-implant marginal bone loss compared with PM technique. Due to heterogeneity of the included studies, their results require cautious interpretation.

Keywords: meta-analysis; peri-implant marginal bone level; platform switching; systematic review.

© 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Figures

Fig 1
Fig 1
Search strategy and results of identification, screening for eligibility and inclusion of publications considered for systematic review and meta-analysis.
Fig 2
Fig 2
Distribution of patients among the test groups (PS) and control groups (PM). n.a., Not announced; PS, platform switching; PM, platform matching.
Fig 3
Fig 3
Distribution of male and female patients among the patients included for the studies. n. a., Not announced.
Fig 4
Fig 4
Distribution of implants among the test groups (PS) and control groups (PM). n. a., Not announced; PS, platform switching; PM, platform matching.
Fig 5
Fig 5
Funnel plot of mean differences of mean marginal bone loss at implants with PS- and PM-implant-abutment configurations. PS, Platform switching; PM, platform matching.
Fig 6
Fig 6
Forest plot of mean differences of effects of PS and PM on marginal bone level changes and two-sided CI95% of all treatment effects. PS, Platform switching; PM, platform matching.

References

    1. Aalam AA, Nowzari H. Clinical evaluation of dental implants with surfaces roughened by anodic oxidation, dual acid-etched implants, and machined implants. The International Journal of Oral and Maxillofacial Implants. 2005;20:793–798.
    1. Aglietta M, Siciliano VI, Rasperini G, Cafiero C, Lang NP, Salvi GE. A 10-year retrospective analysis of marginal bone level changes around implants in periodontally healthy and periodontally compromised tobacco smokers. Clinical Oral Implants Research. 2011;22:47–53.
    1. Albrektsson T, Zarb GA, Worthington P, Eriksson AR. The long-term efficacy of currently used dental implants: a review and proposed criteria of success. The International Journal of Oral Maxillofacial Implants. 1986;1:11–25.
    1. Albrektsson T, Buser D, Sennerby L. On crestal/marginal bone loss around dental implants. The International Journal of Prosthodontics. 2012;25:320–322.
    1. Al-Nsour MM, Chan H-L, Wang H-L. Effect of platform-switching technique on preservation of peri-implant marginal bone: a systematic review. The International Journal of Oral Maxillofacial Implants. 2012;27:138–145.
    1. Annibali S, Bignozzi I, Cristalli MP, La Monaca G, Polimeni A. Peri-implant marginal bone level: a systematic review and meta-analysis of studies comparing platform switching versus conventionally restored implants. Journal of Clinical Periodontology. 2012;39:1097–1113.
    1. Atieh MA, Ibrahim HM, Atieh AH. Platform switching for marginal bone preservation around dental implants: a systematic review and meta-analysis. Journal of Periodontology. 2010;81:1350–1366.
    1. Becker J, Ferrari D, Herten M, Kirsch A, Schaer A, Schwarz F. Influence of platform switching on crestal bone changes at non-submerged titanium implants: a histomorphometrical study in dogs. Journal of Clinical Periodontology. 2007;34:1089–1096.
    1. Becker J, Ferrari D, Mihatovic I, Sahm N, Schaer A, Schwarz F. Stability of crestal bone level at platform-switched non-submerged titanium implants: a histomorphometrical study in dogs. Journal of Clinical Periodontology. 2009;36:532–539.
    1. 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-months follow-up. The International Journal of Oral and Maxillofacial Implants. 2007;22:995–1000.
    1. 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. Journal of Periodontology. 2009;80:609–617.
    1. Esposito M, Murray-Curtis L, Grusovin MG, Coulthard P, Worthington HV. Interventions for replacing missing teeth: different types of dental implants. Cochrane Database of Systematic Reviews. 2007;17:CD003815.
    1. Feloutzis A, Lang NP, Tonetti MS, Burgin W, Brägger U, Buser D, Duff GW, Kornman KS. IL-1 gene polymorphism and smoking as risk factors for peri-implant bone loss in a well-maintained population. Clinical Oral Implants Research. 2003;14:10–17.
    1. Ferraz CC, Anchieta RB, de Almeida EO, Freitas Júnior AC, Ferraz FC, Machado LS, Rocha EP. Influence of microthreads and platform switching on stress distribution in bone using angled abutments. Journal of Prosthodontic Research. 2012;56:256–263.
    1. Heitz-Mayfield LJA, Huynh-Ba G. History of treated periodontitis and smoking as risks for implant therapy. The International Journal of Oral Maxillofacial Implants. 2009;24(Suppl):39–68.
    1. Higgins JPT, Green S. Cochrane Handbook for Systematic Reviews of Interventions. 2011. Version 5.1.0.
    1. 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. Journal of Periodontology. 2008;79:260–270.
    1. Karoussis IK, Kotsovilis S, Fourmousis I. A comprehensive and critical review of the dental implant prognosis in periodontally compromised partially edentulous patients. Clinical Oral Implants Research. 2007;18:669–679.
    1. Laney WR. Glossary of Oral and Maxillofacial Implants. Berlin: Quintessence; 2007. p. 128.
    1. Lang NP, Jepsen S. Consensus report. Implant surfaces and design (working group 4) Clinical Oral Implants Research. 2009;20(Suppl 4):228–231.
    1. Laurell L, Lundgren D. Marginal bone level changes at dental implants after 5 years in function: a meta-analysis. Clinical Implant Dentistry and Related Research. 2011;13:19–28.
    1. Lazzara RJ, Porter SS. A new concept in implant dentistry for controlling postrestorative crestal bone levels. The International Journal of Periodontics and Restorative Dentistry. 2006;26:9–17.
    1. Moher D, Liberati A, Tetzlaff J, Altman DG the Prisma Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Journal of Clinical Epidemiology. 2009;62:1006–1012.
    1. Ong CTT, Ivanovski S, Needleman IG, Retzepi M, Moles DR, Tonetti MS, Donos N. Systematic review of implant outcomes in treated periodontitis subjects. Journal of Clinical Periodontology. 2008;35:438–462.
    1. Papaspyridakos P, Chen C-J, Singh M, Weber HP, Gallucci GO. Success criteria in implant dentistry: a systematic review. Journal of Dental Research. 2012;91:242–248.
    1. Peñarrocha M, Palomar M, Sanchis JM, Guarinos J, Balaguer J. Radiologic study of marginal bone loss around dental implants and its relationship to smoking, implant location, and morphology. The International Journal of Oral Maxillofacial Implants. 2004;19:861–867.
    1. Shibli JA, Iezzi G, Cardoso LA, Onuma T, de Carvalho PSP, d′Avila S, Ferrari DS, Mangano C, Zenóbio EG. Effect of smoking on early bone healing around oxidized surfaces: a prospective, controlled study in human jaws. Journal of Periodontology. 2010;81:575–583.
    1. Strietzel FP, Reichart PA, Kale A, Kulkarni M, Wegner B, Küchler I. Smoking interferes with the prognosis of dental implant treatment: a systematic review and meta-analysis. Journal of Clinical Periodontology. 2007;34:523–544.
References included for systematic review (qualitative analysis)
    1. de Almeida FD, Carvalho ACP, Fontes M, Pedrosa A, Costa R, Noleto JW, de Almeida Barros Mourao CF. Radiographic evaluation of marginal bone level around internal-hex implants with switched platform: a clinical case report series. The International Journal of Oral Maxillofacial Implants. 2011;26:587–592.
    1. Cappiello M, Luongo R, di Iorio D, Bugea C, Cocchetto R, Celletti R. Evaluation of peri-implant bone loss around platform-switched implants. The International Journal of Periodontics and Restorative Dentistry. 2008;28:347–355.
    1. Dursun E, Tulunoglu I, Canpinar P, Uysal S, Akalin FA, Tözüm TF. Are marginal bone levels and implant stability affected by single-stage platform switched dental implants? A comparative clinical study. Clinical Oral Implants Research. 2012;23:1161–1167.
    1. Fickl S, Zuhr O, Stein JM, Hürzeler MB. Peri-implant bone level around implants with platform-switched abutments. The International Journal of Oral Maxillofacial Implants. 2010;25:577–581.
    1. Linkevicius T, Apse P, Grybauskas S, Puisys A. Influence of thin mucosal tissues on crestal bone stability around implants with platform switching: a 1-year pilot study. Journal of Oral and Maxillofacial Surgery. 2010;68:2272–2277.
    1. Veis A, Parissis N, Tsirlis A, Papadeli C, Marinis G, Zogakis A. Evaluation of peri-implant marginal bone loss using modified abutment connections at various crestal level placements. The International Journal of Periodontics and Restorative Dentistry. 2010;30:609–617.
    1. Vigolo P, Givani A. Platform-switched restorations on wide-diameter implants: a 5-year clinical prospective study. The International Journal of Oral Maxillofacial Implants. 2009;24:103–109.
References included for meta-analysis
    1. Canullo L, Fedele GR, Iannello G, Jepsen S. Platform switching and marginal bone level alterations: the results of a randomized-controlled trial. Clinical Oral Implants Research. 2010;21:115–121.
    1. Canullo L, Goglia G, Iurlaro G, Iannello G. Short-term bone level observations associated with platform switching in immediately placed and restored single maxillary implants: a preliminary report. International Journal of Prosthodontics. 2009;22:277–282.
    1. Canullo L, Rosa JC, Pinto VS, Francischone CE, Götz W. Inward-inclined implant platform for the amplified platform-switching concept: 18-month follow-up report of a prospective randomized matched-pair controlled trial. The International Journal of Oral and Maxillofacial Implants. 2012;27:927–934.
    1. Crespi R, Capparè P, Gherlone E. Radiographic evaluation of marginal bone levels around platform-switched and non-platform-switched implants used in an immediate loading protocol. The International Journal of Oral Maxillofacial Implants. 2009;24:920–926.
    1. Enkling N, Jöhren P, Klimberg V, Bayer S, Mericske-Stern R, Jepsen S. Effect of platform switching on peri-implant bone levels: a randomized clinical trial. Clinical Oral Implants Research. 2011;22:1185–1192.
    1. Fernández-Formoso N, Rilo B, Mora MJ, Martínez-Silva I, Díaz-Afonso AM. Radiographic evaluation of marginal bone maintenance around tissue level implant and bone level implant: a randomised controlled trial. A 1-year follow-up. Journal of Oral Rehabilitation. 2012;39:830–837.
    1. Gultekin BA, Gultekin P, Leblebicioglu B, Basegmez C, Yalcin S. Clinical evaluation of marginal bone loss and stability in two types of submerged dental implants. The International Journal of Oral and Maxillofacial Implants. 2013;28:815–823.
    1. Hürzeler MB, Fickl S, Zuhr O, Wachtel HC. Peri-implant bone level around implants with platform-switched abutments: preliminary data from a prospective study. Journal of Oral and Maxillofacial Surgery. 2007;65(Suppl 1):33–39.
    1. Kielbassa AM, de Fuentes RM, Goldstein M, Arnhart C, Barlattani A, Jackowski J, Knauf M, Lorenzoni M, Maiorana C, Mericske-Stern R, Rompen E, Sanz M. Randomized controlled trial comparing a variable-thread novel tapered and a standard tapered implant: interim one-year results. The Journal of Prosthetic Dentistry. 2009;101:293–305.
    1. Peñarrocha-Diago MA, Flichy-Fernández AJ, Alonso-González R, Peñarrocha-Oltra D, Balaguer-Martínez J, Peñarrocha-Diago M. Influence of implant neck design and implant-abutment connection type on peri-implant health. Radiological study. Clinical Oral Implants Research. 2012;24:1192–1200.
    1. Pieri F, Aldini NN, Marchetti C, Corinaldesi G. Influence of implant-abutment interface design on bone and soft tissue levels around immediately placed and restored single-tooth implants: a randomized controlled clinical trial. The International Journal of Oral Maxillofacial Implants. 2011;26:169–178.
    1. 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 postoperative crestal bone loss. The International Journal of Oral Maxillofacial Implants. 2009;24:299–308.
    1. Telleman G, Raghoebar GM, Vissink A&, Meijer HJA. Impact of platform switching on peri-implant bone remodelling around short implants in the posterior region, 1-year results from a split-mouth clinical trial. Clinical Implant Dentistry and Related Research. 2012a doi: . [Epub ahead of print]
    1. Telleman G, Raghoebar GM, Vissink A, Meijer HJA. Impact of platform switching on inter-proximal bone levels around short implants in the posterior region; 1-year results from a randomized clinical trial. Journal of Clinical Periodontology. 2012b;39:688–697.
    1. Trammell K, Geurs NC, O′Neal SJ, Lui P-R, Haigh SJ, McNeal S, Kenealy JN, Reddy MS. A prospective, randomized, controlled comparison of platform-switched and matched-abutment implants in short-span partoial denture situations. The International Journal of Periodontics and Restorative Dentistry. 2009;29:599–605.

Source: PubMed

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