Concept, History, and Rationale
- Dental implants undergo osseointegration, fusing with the surrounding bone.
- Restorative abutments are placed on implants to support dental restorations.
- Platform matching refers to using abutments with the same diameter as the implant platform.
- Platform switching involves using narrower abutments on wider implants.
- Platform switching can help preserve alveolar bone levels around dental implants.
- Wide-diameter dental implants were introduced in the late 1980s.
- Mismatched standard-diameter abutments were used due to lack of availability.
- Platform switched implants showed less initial crestal bone loss.
- Early clinical reports demonstrated enhanced tissue responses to platform switched implants.
- Many implant companies incorporated platform switching into their systems.
- Bone resorption occurs at the crest of bone following implant placement.
- The implant-abutment junction (IAJ) plays a role in bone resorption.
- Platform switching repositions the IAJ away from the outer edge of the implant.
- Inflammatory infiltrate is contained within the width of the platform switch.
- The magnitude of the implant-abutment diameter mismatch affects the benefits of platform switching.
Proposed Benefits
- Platform switching helps preserve the biologic width around implants.
- Vertical bone loss at the coronal aspect of implants is reduced.
- Horizontal component of the biologic width is minimized.
- Crestal bone loss between adjacent implants is decreased.
- Platform switching allows implants to be placed closer together while maintaining more crestal bone.
Biologic Width
- Biologic width is the minimum thickness of soft tissue surrounding implants.
- Biologic width formation leads to bone loss in the vertical dimension.
- Continuous removal of abutments disrupts tissue attachment and causes bone loss.
- Vertical bone loss diminishes bone-to-implant contact and stability.
- Biologic width has been well researched and documented.
Platform Switching and the Vertical Component of Biologic Width
- Implant platform exposure allows for the formation of junctional epithelium and soft connective tissue.
- Less bone resorption is required for attachment on the lateral surface of the implant fixture.
- Platform switching can reduce vertical bone resorption by up to 70%.
- The abutment is narrower in diameter than the implant fixture.
- The exposed area of the platform contributes to the formation of the biologic width.
Platform Switching and the Horizontal Component of Biologic Width
- Platform switching can shift the implant-abutment junction away from peri-implant bone.
- Implants placed close together or near a thin buccal plate benefit from platform switching.
- The inflammatory zone at the microgap of the implant-abutment junction is mitigated.
- The horizontal extent of bone loss can be reduced.
- The implant-abutment junction (IAJ) is shifted onto the implant platform.
In dentistry, platform switching is a method used to preserve alveolar bone levels around dental implants. The concept refers to placing screwed or friction fit restorative abutments of narrower diameter on implants of wider diameter, rather than placing abutments of similar diameters, referred to as platform matching.
Discovered by accident in the late 1980s, the benefits of platform switching have become the focus of implant-related research with increasing frequency. Numerous peer-reviewed articles and recent systematic reviews have revealed that platform switching can be considered a means of preventing initial peri-implant bone loss.
