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 minimised. - 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.