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322292.platform switch -_to_be_or_not_to_be_ver_5.1

  1. 1. Platform switch – to be or not to be? Andrija Petar Bošnjak School of Dental Medicine, Zagreb, Croatia Andrej Meniga Private practice, Zagreb, Croatia Ann Wennerberg, Victoria Fröjd School of Dentistry, Göteborg, Sweden
  2. 2. Background Bone resorption to the first thread during initial loading Biologic width around implants (Berglundh & Lindhe 1996) No resorption when an abutment with a narrower diamater is connected to the implant (Gardner 2005) – so called platform-switching
  3. 3. Objective Evaluation of the difference in histological findings between a platform-switching implant-to- abutment interface using a tight seal and a flat-to- flat interface Differences in ISQ values during 3 months for implants with transmucosal healing (one-stage procedure)
  4. 4. Material and methods 26 consecutive patients treated with 43 Ospol study implants 4.0 diameter, implant length of 10, 12 and 15 mm supporting single crowns or fixed partial dentures 36 implants (83.7%) – single tooth replacements in lateral parts of mandible (58.8%) and maxilla (41.2%)
  5. 5. Material and methods Paired implants  One with a healing abutment – creating flat-to-flat interface  One with a standard abutment – creating platform switch interface
  6. 6. Material and methods 2×2 mm biopsy of soft tissue was acquired 3 months after implant placement for histological evaluation (at the time of crown/fixed partial denture fixation) Immersed in sodium-cacodylate solution and subsequently analyzed
  7. 7. Material and methods Radiographic assessment of marginal bone level At the time of implant placement At 3 months recall (time of crown fixation) All patients were recalled monthly during osseointegration process ISQ measurements at the time of surgery and 3 months postoperatively
  8. 8. Results Cross-sections of fixated samples Inflammatory cell inflitrate Thickness of the epithelium Thickness of the connective tissue
  9. 9. Platform switch No substantial number of inflammatory cells Epithelial thickness Well-defined “rete pegs” Connective tissue layer
  10. 10. Flat-to-flat No substantial inflammatory cell infiltrate Epithelial thickness Connective tissue layer
  11. 11. ISQ measurements Platform-switch (± SD) Flat-to-flat (± SD) p At implant placement 72.5 ± 6.3 71.8 ± 5.9 NS At 1 month 77.3 ± 4.2 77.1 ± 3.8 NS At 3 months 81.8 ± 5.5 80 ± 4.7 NS
  12. 12. Conclusion Histologic analysis is in the early stage, but there is no significant inflammatory cell infiltrate Platform-switch seems to be as reliable for one- stage procedures as flat-to-flat interface ISQ measurements confirm that the stability was maintained during initial three months of healing
  13. 13. Further developments
  14. 14. Further developments
  15. 15. Further developments
  16. 16. Acknowledgments Ospol, Malmö, Sweden Göran Urde & Hans Berglund @ Ospol, Malmö, Sweden Petra Hammarström Johansson @ Dept Biomaterials/Handicap Research, Göteborg, Sweden Martina Vlah, Gordana Sporis & Lana Vodopija @ Meniga & Bosnjak LLC, Zagreb, Croatia Kresimir Sankovic, School of Pharmacy, Zagreb, Croatia Drazen Jovicevic, Dental Laboratory, Zagreb, Croatia