THE CONCEPT OF PLATFORM SWITCHING

Öz

Platform switching is obtained by using narrower diameter abutment over wide diameter implant platform. To obtain more bone contact area and more primer stabilization in post implantation period, 5.0 and 6.0 mm wide-diameter platforms were produced but because of the matching diameter prosthetic componenets were not available, these wide implants were restorated standard-diameter (4.1 mm) prosthetic components. Long-term radiographic follow up of these wide diameter implants has demonstrated a smaller than expected vertical change in crestal bone height. This concept which the outer edge of the implant- abutment interface horizontally respositoned inwardly is called platform switching. The aim of this review is to discuss the advantage and disadvantages of platform switching and review the current literatures covering the studies about this concept

Anahtar Kelimeler

• Implant
• abutment junction
• platform switching

PLATFORM SWITCHING KONSEPTİ

Öz

Platform switching konsepti dental implantlarda protetik parça platform genişliğinin  implant platformunun çapına oranla daha küçük tutulması esasına dayanır. Önceki yıllarda daha fazla kemik kontak alanı ve implantasyon sonrası daha fazla primer stabilizasyon elde edilebilmesi için 5.0 ve 6.0 mm çapında geniş platformlar üretilmiş, fakat bu çapta dayanaklar mevcut olmadığı için bu implantlar standart çapta (4.1mm)  protetik komponentlerle restore edilmiştir. Uzun dönem radyografik takip çalışmaları sonunda dar çaplı dayanaklarla restore edilmiş vakalarda daha az krestal kemik kaybı gözlenmiştir. İmplant-dayanak bağlantısının horizontal olarak daha merkezde konumlandığı bu konsepte “platform switching” adı verilmiştir. Bu derlemenin amacı, platform switching konseptinin avantajlarını, dezavantajlarını ve bu konsept ile ilgili olarak yapılmış çalışmaları gözden geçirmektir.

Anahtar Kelimeler

• İmplant
• dayanak bağlantısı
• platform switching

Kaynakça

1. Calvo Guirado JL, Saez Yuguero MR, Pardo Zamora G, Muñoz Barrio E. Immediate provisionalization on a new implant design for esthetic restoration and preserving 2007;16:155-64. bone. Implant Dent
2. Serrano-Sánchez P, Calvo-Guirado JL, Manzanera- Pastor E, Lorrio-Castro C, Bretones-López P, Pérez- Llanes JA. The influence of platform switching in dental implants. A literature review. Med Oral Patol Oral Cir Buca. 2011;16:400-5.
3. Kwon H, Lee D, Park K, Kim C, Moon I. Influence of the Tooth- and Implant-Side Marginal Bone Level on the Interproximal Papilla Dimension in a Single Implant With a Microthread, Conical Seal, and Platform-Switched Design. Journal of Periodontology 2009; 80: 1541-7.
4. Kim DM, Badovinac RL, Lorenz RL, Fiorellini JP, Weber HP. A 10 year prospective clinical and radiographic study of one stage dental implants. Clinical Oral Implants Res 2008; 254-8.
5. Priest GF. The esthetic challenge of adjacent implants. J Oral Maxillofac Surg 2007;65:2-12.
6. Albrektsson T, Zarb GA, Worthington P, et al. The long-term efficacy of currently used dental implants: A review and proposed criteria of success. Int J Oral Maxillofac Implants 1986;1:1- 25.
7. Oh TJ, Yoon J, Misch CE, Wang HL. The causes of early implant bone loss: Myth or science? J Periodontol 2002;73:322–33.
8. Hermann JS, Buser D, Schenk RK, Cochran DL. Crestal bone changes around titanium implants. A histometric evaluation of unloaded non-submerged and submerged implants in the canine mandible. J Periodontol 2000;71:1412–24.

9. 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;22:255–61.
10. Lazzara RJ, Porter SS. Platform switching: A new concept in implant dentistry for controlling postrestorative crestal bone levels. Int J Periodontics Restorative Dent 2006;26:9–17.
11. Maeda Y, Miura J, Taki I, Sogo M. Biomechanical analysis on platform switching: Is there any biomechanical rationale? Clin Oral Implants Res 2007;18:581–4.
12. Miyata T, Kobayashi Y, Araki H, Ohto T, Shin K. The influence of controlled occlusal overload on peri-implant tissue. Part 3: A histologic study in monkeys. Int J Oral Maxillofac Implants
13. Canay S, Akça K. Biomechanical aspects of bone- level diameter shifting at implant-abutment interface. Implant Dent 2009;18:239-48.
14. Baggi L, Cappelloni I, Di Girolamo M, Maceri F, Vairo G. The influence of implant diameter and length on stress distribution of os seointegrated implants related to crestal bone geometry: a three- dimensional finite element analysis. J Prosthet Dent 2008;100:422-31.
15. Hsu JT, Fuh LJ, Lin DJ, Shen YW, Huang HL. Bone strain and interfacial sliding analyses of platform switching and implant diameter on an immediately loaded dimensional finite element analyses. J Periodontol 2009;80:1125-32. and three
16. Schrotenboer J, Tsao YP, Kinariwala V, Wang HL. Effect of platform switching on implant crest bone stress: a finite element analysis. Implant Dent 2009;18:260-9.
17. Tabata LF, Assunção WG, Adelino Ricardo Barão V, de Sousa EA, Gomes EA, Delben JA. Implant platform switching: biomechanical approach using two-dimensional finite element analysis. J Craniofac Surg 2010;21:182-7.
18. Rodríguez-Ciurana X, Vela-Nebot X, Segalà-Torres M, Rodado-Alonso C, Méndez-Blanco V, Mata- Bugueroles M. Biomechanical repercussions of bone resorption related to biologic width: a finite element analysis of three implant-abutment configurations. Int J Periodontics Restorative Dent 2009;29:479-87.
19. Sabet ME, El-Korashy DI, El-Mahrouky NA. Effect of platform switching on strain developed around implants supporting mandibular overdenture. Implant Dent 2009;18:362- 70.
20. Wagenberg B, Froum SJ. Prospective study of 94 platform-switched implants observed from 1992 to 2006. Int J Periodontics Restorative Dent 2010;30:9-17.
21. Spray JR, Black CG, Morris HF, Ochi S. The influence of bone thickness on facial marginal bone response: stage 1 placement through stage 2 uncovering. Ann Periodontol 2000;5:119-28.
22. Cappiello M, Luongo R, Di Iorio D, Bugea C, Cocchetto R, Celletti R. Evaluation of peri-implant bone loss around platform-switched implants. Int J Periodontics Restorative Dent 2008;28:347-55.
23. López-Marí L, Calvo-Guirado JL, Martín-Castellote B, Gomez-Moreno G, López-Marí M. Implant platform switching concept: an updated review. Med Oral Patol Oral Cir Buca. 2009;14:e450-4.
24. 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;24:299- 308.
25. Tarnow DP, Cho SC, Wallace SS. The effect of inter-implant distance on the height of inter- implant bone crest. J Periodontol 2000;71:546-9.
26. Calvo Guirado JL, Ortiz Ruiz AJ, Gómez Moreno G, López Marí L, Bravo González LA. Immediate loading and immediate restoration in 105 expanded-platform implants via the Diem System after a 16-month follow-up period. Med Oral Patol Oral Cir Bucal 2008;13:E576-81.
27. Rodríguez-Ciurana X, Vela-Nebot X, Segalà-Torres M, Calvo-Guirado JL, Cambra J, Méndez-Blanco V, Tarnow DP. The effect of interimplant distance on the height of the interimplant bone crest when using Periodontics Restorative Dent 2009;29:141-51.
28. Hürzeler M, Fickl S, Zuhr O, Wachtel HC. Peri- implant bone level around implants with platform- switched abutments: preliminary data from a prospective study. J Oral Maxillofac Surg. 2007 Jul;65(7 Suppl 1):33-9. Erratum in: J Oral Maxillofac Surg 2008;66:2195-6.
29. 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;22:995-1000.
30. Trammell K, Geurs NC, O’Neal SJ, Liu PR, Haigh SJ, McNeal S, et al. A prospective, randomized, controlled comparison of platform-switched and matched-abutment implants in short-span partial denture situations. Int J Periodontics Restorative Dent 2009;29:599-605.
31. de Almeida FD, Carvalho AC, Fontes M, Pedrosa A, Costa R, Noleto JW, Mourão CF. Radiographic evaluation of marginal bone level around internal- hex implants with switched platform: a clinical case report series. Int J Oral Maxillofac Implants
32. Canullo L, Fedele GR, Iannello G, Jepsen S. Platform switching and marginal bone-level alterations: the results of a randomized-controlled trial. Clin Oral Implants Res 2010;21:115-21
33. 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 Implants Res 2009;20:414-20.
34. Cappiello M, Luongo R, Di Iorio D, Bugea C, Cocchetto R, Celletti R. Evaluation of peri-implant bone loss around platform-switched implants. Int J Periodontics Restorative Dent 2008;28:347-55.
35. Crespi R, Capparè P, Gherlone E. Radiographic evaluation of marginal bone levels around platform-switched implants used in an immediate loading protocol. Int J Oral Maxillofac Implants 2009;24:920-6.