SWITCHING
KONSTANTIN GROMOV, DDS
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PLATFORM
The termPlatform Switching
2006
1991 - wider implants for soft bone and lack of stability), standard 4mm components - less bone loss
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2001
Apical migration of JE to protect the internal part of the body from inammation
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PS?
Soft tissue <3mm - remodeling
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1997
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Soft tissue thickness effect on bone loss and relation to PS
THIN<4.22mm<THICK + PS = enough room for BW
7x9mm
LESS BONE LOSS !
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No initial x-rays(?)
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2008
Biomet 3i Prevail 4/5/4 was removed after 2 months from a patient
0.35 mm
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2009
Immediate placement, external hex vs PS - no difference Supra-crestal placement - external hex?
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2009
5 year follow-up, almost no bone loss 20-30 Ncm for IL (vs 30-40 Ncm) Morse connection - cold welding Esthetics, emergence prole? Quite a lot narrow 3,5mm implants
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2007
2 mm sub-crestally, loaded, retrieved 1 month Almost none inammatory cells, no brotic tissue
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Extreme PS, one connection Very easy surgical part, 20-30Ncm - IL Bone stability Questionable esthetics for single units, FPDs Unusual Prosth
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2.53 mm
vs 0.76 mm
Benets of an Implant Platform Modication Technique to Reduce Crestal Bone Resorption Xavier Vela-Nebot, MD, DDS,* Xavier Rodr guez-Ciurana, MD, Carlos Rodado-Alonso, MD,
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180
90
Plaque induced inammation vs Micro-gap induced inammation Mesializing micro-gap, causing inammatory cell inltrate (ICT) Shifts the mechanical stress away from coronal bone-impl interface Reestablishment of BW horizontal component
Moreover, with the increased surface area created by the exposed implant seating surface, there might be a reduction in the amount of crestal bone resorption necessary to expose a mini- mum amount of implant surface to which the soft tissue can attach (Lazzara & Porter 2006).
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2012
Disconnecting - reconnecting healing abutments (5 times) PS - circular pattern of CT bers at platform NPS - at the rst thread
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9 MONTHS
2010
ridge>7mm, two-stage micro threads, internal connection early cover screw exposure - exclusion from the study
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2009
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2 mm
2013
4 mm
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SWITCHING
No difference single-stage vs two-stage Esthetic considerations, location of the implant (TL?) Need 3-4 mm of soft tissue for PS to work One abutment-one time protocol No universal implant system Always think about the restorative outcome INFLAMMATION - BONE LOSS!
Wednesday, May 29, 13
PLATFORM
History Biology Benets Disadvantages Measurements Design variety (prevale, ankylos, astra, built-in by def. how many mm? need more than .35?
or just versality of abt) - 1-piece-2-pice (welding impl article?) Summary extras: 1 abt-1 time, emergence vs PS PS vs external hex (tissue level) No bone loss - wheres bone level initially? loosing 1.5-2mm after abt (healing) connection vertical positioning of the platform - ? at, below, above 0.4mm??,(piattelli) sloped platform switching, one abt-one time (desturbance articles?) graphics - positioning of the impl - what might happen bers orientation NPS vs PS connecting-reconnecting components - is epithelial faster than connective tissue? bone growth over the PS ? tapered, morse - less mobility 15-20Ncm - enough IL(?) - cold welding
show graphic - related articles and studies concl - no diff 1vs2stage, PS when possible, TL when possible (even better), 3-4mm soft
tissue, one abutm one time, ANKYLOS when thin tissue(?) and no esthetics
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