See discussions, stats, and author profiles for this publication at: https://www.researchgate.

net/publication/348957917

Platform switching implant

Article in IP International Journal of Periodontology and Implantology · January 2020

DOI: 10.18231/j.ijpi.2019.032

CITATIONS READS

0 287

4 authors, including:

Veena Kalburgi Pooja Bharadwaj

People’s University LNCT Group of Colleges
32 PUBLICATIONS 187 CITATIONS 23 PUBLICATIONS 4 CITATIONS

SEE PROFILE SEE PROFILE

All content following this page was uploaded by Pooja Bharadwaj on 02 April 2022.

The user has requested enhancement of the downloaded file.

 IP International Journal of Periodontology and Implantology 2019;4(4):152–154

Content available at: iponlinejournal.com

IP International Journal of Periodontology and Implantology

Journal homepage: www.innovativepublication.com

Short Communication
Platform switching implant

Sumedha Srivastava1, *, Veena Kalburgi1 , Kapil Jain1 , Pooja Bharadwaj1

1 Dept. of Periodontology, Peoples College of Dental Science and Research Centre, Bhopal, Madhya Pradesh, India

ARTICLE INFO ABSTRACT

Article history: For the implant to function successfully, there should be a good integration between implant, hard, and
Received 30/10/2019 soft tissue. The implant should be able to provide esthetics, good functioning of the masticatory muscles,
Accepted 13/11/2019 phonetics, and above all to minimize the crestal bone loss and hence maintaining the crestal bone levels.
Available online 07-01-2020 Over the recent years, as compared to traditional implants which resulted in bacterial accumulation,
inflammatory cell infiltrate and violation of biologic width and thus bone loss and hence compromising
implant integrity, platform switching implants have proved to be better option in maintain crestal bone
Keywords:
levels by keeping the inflammatory infiltrate away from the crestal bone, allowing horizontal and vertical
Platform switching
extension of biologic width, equalize the distribution of stress to centre of implant and ultimately can help
Biologic width to preserve the crestal bone levels.
Crestal Bone
Inflammatory infiltrate © 2019 Published by Innovative Publication. This is an open access article under the CC BY-NC-ND
Traditional implants license (https://creativecommons.org/licenses/by/4.0/)

1. Introduction the abutment, traumatic surgical technique, shape and size

of the abutment.
To provide the patients with good oral health is the
main purpose of the dentistry. In case of the patients
Hence the concept of platform switching (discovered
who have few teeth or are completely edentulous have
accidently) was introduced and later on become one of the
poor masticatory ability, esthetics and speech. Such
better optiob for the modern dentistry in relation to the
patients wearing the removal partial denture or complete
preservation of crestal bone levels as it has the abutment
denture have their esthetics, masticatory ability reduced
that i s narrower than the implant that has wider collar. This
as compared to natural dentition. Considering all these
type of connection has the ability to deal with various major
factors, now a days implant is one of the better option
and minor factors associated with crestal bone loss.
in comparison to removable partial denture or complete
denture. But one of the fact that should be kept in mind
is the maintainance of crestal bone levels following implant
placement. In case of traditional implants there is always 1.1. History
a certain amount of crestal bone loss during first year after
placement of implant because of inflammatory infiltrate that
forms around the implant as well as due to violation of In 1980 wider diameter implants were used. This was
biologic width. This was first reported by Adell et al. 1 the period were due to lacking of commercially available
Apart from these two major factors, there are various minor components, mismatched diameter implant and abutment
factors that are associated with the crestal bone loss. These were used. But later on it was found that due to this
factors are the presence of microgap between implant and difference in the diameter of implant and abutment, there
was a reduction in crestal bone loss (as firstly described by
* Corresponding author. Lazzara, Porter, and gardner) who introduced the concept of
E-mail address: [email protected] (S. Srivastava). platform switching implants in literature.

https://doi.org/10.18231/j.ijpi.2019.032
2581-9836/© 2019 Innovative Publication, All rights reserved. 152
 Srivastava et al. / IP International Journal of Periodontology and Implantology 2019;4(4):152–154 153

1.2. Rationale 4. Decreased abutment diameter can result in fracture

of the abutment as because of smaller size abutment,
Following the use of traditional implant, there is always
stresses are more concentrated near the abutment.
certain amount of bone loss. To prevent this bone loss, there
needs to be the movement of inflammatory cell infiltrate
away(which is located 0.75mm above and 0.75 mm below 1.7. Advantages
the implant abutment junction) away from the crestal bone,
increament in the surface area at the implant abutment 1. Since the abutment is smaller in diameter than the
junction (by horizontal and vertical extension of biologic implant neck hence it helps to provide more effective
width) and equal distribution of mechanical stress at the soft tissue seal.
coronal portion of impant (hence reduction of microgap). 2. Equal distribution of stress.
But the traditional implant lack these characteristics as 3. Prevent or minimize the crestal bone resorption as the
compared to platform switching implant which fulfill all inflammatory infiltrate moves away from the crestal
these criteria and hence reduction of crestal bone loss. Thus bone.
this the main rationale to use the platform switching implant 4. Results in a horizontal extension of the biologic width.
in dentistry in recent years. 5. Provides bone support for shorter implants.
6. Platform switching implants can be placed in the area
1.3. Concept of platform switching where aesthetics is of major concern.
7. Improved implant stability and thus enhanced
The implant is always surrounded by the soft tissue seal.
longevity.
This seal is present both laterally and apically. In case of two
traditional implants, if they are placed close together, then
it will result in increase vertical bone loss between the two 1.8. Disadvantages
implants. However in case of platform switching implant,
due to difference in diameter of implant and abutment, when 1. Esthetics can be compromised if there is no sufficient
these two implants are placed together, it will result in space.
horizontal and vertical extension of biologic width and as a 2. Similar design of the components is essential for the
result of which there will be the movement of microbes (and platform switched implants to function properly.
thus inflammatory cell infiltrate away from crestal bone),
uniform distribution of stress in the centre of implant and
thus preservation of crestal bone levels. 1.9. Non-platform switched to platform switched
implants
1.4. Microbiota associated with platform switching
implant Many factors should be considered while planning for the
placement of implant. Various studies have been done
It was found by Canullo et al 2 that the microbiota associated by various researchers that gives us the indication that
with the platform switching implant in was Streptococcus platform switching implants are one of the better option
sanguis,mitis oralis V. Parvula, Actinomyces, P. gingivalis. as compared to the traditional implants. A study was
conducted by Markus Hurzeler et al 3 for the comparison
1.5. Indications of bone loss between platform switching implant and non
platform switching implant and by his study he concluded
1. If the residual bone height is limited by the anatomic
that marginal bone loss was more in non platform switched
structures present.
implant as compared to platform switched implant. Vela
2. If there is a need for the placement of shorter implants
N et al 4 conducted the study on the horizontal circular
in the atrophic area.
extension of biologic width and found that this extension
3. When the distance between the two implants is less
was more in platform switching implant as compared to non
than 3 mm i.e. in the narrow edentulous ridge.
platform switching implant. Amount of vertical bone loss
4. When aesthetics is of major concern. 5
was compared by Cappiello et al and he found that it was
minimal in platform switching implant as compared to non
1.6. Limitations
platform switched implants. Lazzara, Porter 6 during the 13
1. Normal size abutments require larger implants years radiographic period found that crestal bone loss was
2. Normal implants require smaller abutments as if it is more in non platform switching implants as compared to
not so then the esthetics would be compromised. platform switching implants. A study was conducted by
3. Three to four mm of soft tissue seal is essential for Degidi 7 on the microgap of platform switching and non
the platform switched implants to prevent the bone platform switching implants and he concluded that there
resorption. was zero microgap in case of platform switching implants.
154 Srivastava et al. / IP International Journal of Periodontology and Implantology 2019;4(4):152–154

Fig. 1:

2. Discussion 5. Conflict of interest

The most important criteria for the implant to function None.
successfully is the preservation of crestal bone levels.
Traditional implants lack this criteria as there is always References
a certain amount of bone loss by these implants. Hence 1. Adell R, Lekholm U, Rockler B, Branemark PI. A 15-year study of
in this regard, platform switching implants are one of the osseointegrated impants in the treatment of theedentulous jaw. Int J
better option to prevent the crestal bone loss by moving Oral Surg. 1981;10:387–416.
the inflammatory cell infiltrate away from the crestal bone, 2. Canullo L, Quaranta A, Teles RP. The microbiota associated with
implants restored with platform switching: A preliminary report. J
by preservation of biologic width and by reduction of Periodontal. 2010;81:403–411.
8
microgap. Baumgarten et al described the platform 3. Hurzeler M, Fickl S, Zuhur O, Wachtel HC. Peri-implant bone level
switching technique and its usefulness in situations where around implants with platform-switched abutments: Preliminary data
from a prospective study. J Oral Maxillofac Surg. 2007;65:33–39.
shorter implants must be used, where implants are placed in 4. Vela N. Benefits of fan implant platform modification technique to
the esthetic zone and where a larger implant is desirable, but reduce crestal bone resorption. Implant Dent. 2006;15:313–320.
prosthetic space is limited. They believed that a sufficient 5. Cappiello M. Evaluation of Peri-implant bone loss around platform-
tissue depth of approximately 3 mm or more is necessary switched implants. Int J Periodont Restorat Dent. 2008;28:347–355.
6. Lazzara RJ, Porter SS. Platform switching: A new concept in implant
to accommodate an adequate biologic width. Platform dentistry for controlling post restorative crestal bone levels. Int J
switching implant prevent the crestal bone loss and thus Periodontics Restorative Dent. 2006;26:9–17.
9
preserves the crestal bone. Cappiello et al found that 7. Degidi M, lezzi G, Scarano A, Piatteli A. Immediately loaded
titanium implant with a tissue-stabilizing/maintaining design (beyond
microgap is an important factor in the remodeling of peri-
platform switch) retrieved from man after 4 weeks: A histological and
implant crestal bone and platform switching implant helps histomorphometrical evaluation: A case report. Clin Oral Implants Res.
to reduce this microgap and thus preventing the crestal bone 2008;19:276–282.
resorption. 8. Baumgarten H. A new implant design for crestal bone preservation:
Initial observations and case report. Pract Proced Aesthet Dent.
2005;17:735–740.
3. Conclusion 9. Cappiello M. Evaluation of Peri-implant bone loss around platform-
switched implants. Int J Periodont Restorat Dent. 2008;28:347–355.
One of the advantage of platform switching implant is
the equal distribution of mechanical stress at the centre of
the implant, horizontal and vertical extension of biologic Author biography
width and moving inflammatory cell infiltrate away from
the crestal bone thus preventing or minimizing the crestal Sumedha Srivastava Reader
bone loss. Platform switching implants has proved to be
one of the better option in these recent years as it fulfill Veena Kalburgi Professor and Head of Department
all the factors that are essential for the implant to function
Kapil Jain Professor
successfully.
Pooja Bharadwaj Post Graduate Student
4. Source of funding
None.
Cite this article: Srivastava S, Kalburgi V, Jain K, Bharadwaj P.
Platform switching implant. Int J Periodontol Implantol
2019;4(4):152-154.

View publication stats