Transcript Platform switch – to be or not to be?

Platform switch –
to be or not to be?
Andrija Petar Bošnjak
School of Dental Medicine, Zagreb, Croatia
Andrej Meniga
Private practice, Zagreb, Croatia
Ann Wennerberg, Victoria Fröjd
School of Dentistry, Göteborg, Sweden
Background
 Bone resorption to the first thread during initial
loading
 Biologic 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
Objective
 Evaluation of the difference in histological
findings between a platform-switching implant-toabutment interface using a tight seal and a flat-toflat interface
 Differences in ISQ values during 3 months for
implants with transmucosal healing (one-stage
procedure)
Material and methods
 26 consecutive patients treated with 43 Ospol
study implants
 4.0 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 methods
 Paired 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 methods
 Radiographic assessment of marginal bone level
 At the time of implant placement
 At 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
Results
 Cross-sections of fixated samples
 Inflammatory cell inflitrate
 Thickness of the epithelium
 Thickness 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
Conclusion
 Histologic analysis is in the early stage, but there is
no significant inflammatory cell infiltrate
 Platform-switch seems to be as reliable for onestage procedures as flat-to-flat interface
 ISQ measurements confirm that the stability was
maintained during initial three months of healing
Further developments
Further developments
Further developments
Acknowledgments
 Ospol, Malmö, Sweden
 Göran Urde & Hans Berglund @ Ospol, Malmö, Sweden
 Petra Hammarström Johansson @ Dept Biomaterials/Handicap
Research, Göteborg, Sweden
 Martina Vlah, Gordana Sporis & Lana Vodopija @ Meniga &
Bosnjak LLC, Zagreb, Croatia
 Kresimir Sankovic, School of Pharmacy, Zagreb, Croatia
 Drazen Jovicevic, Dental Laboratory, Zagreb, Croatia