Platform switching and a microstructured bioactive surface for osseointegrated implants: a key success factor

Background: Platform switching is a major contributing factor in limiting crestal bone resorption. Biological width is necessary to maintain the soft tissues and hard tissue. Aim: The aim of this work is to evaluate the importance of the platform switching and of new implant surfaces to decrease marginal bone resorption and to avoid complications. Material and Methods: The use of available prosthetic components led to a mismatch between the diameters of the implants and the prosthetic abutments. This mismatch was termed platform switching. This study has focused on radiographic observation of the crestal bone level around implants restored with platform switching (481 implants in 160 patients) comparing them to rehabilitation with implant/abutment switched diameters (400 implants in 150 patients). Different titanium surface preparations have been compared too. Results: The platform-switched implants result in lesser marginal bone resorption (p<0.01). Microstructured and bioactive surfaces show higher bone contact values and therefore lead to an improved osseointegration, reducing healing time too (p<0.01). Conclusion: Implants with platform switching could avoid complications and enhance osseointegration success rate limiting alveolar crestal bone remodeling and resorption at the abutment/implant interface. Also the behavior of dental implants is significantly influenced by the surface characteristics of the implants. The platform switching reduces crestal bone by shifting the inflammatory cell infiltrate inward and away from the adjacent crestal bone.