Abstract
Minimising marginal bone loss around dental implants is of paramount importance. The success of methods such as platform switching (PS) and laser-micro-texturing (LM) are well documented. Whether or not a combination of these designs will further improve outcomes has not been studied previously. Hence, this prospective, randomized controlled single-centre pilot study compared the clinical and microbiological outcomes of implants with both PS and LM (test) to implants with only LM (control). A test and control implant were placed in thirteen patients totalling 26 implants. The primary investigated outcome was marginal bone level (MBL); secondary outcomes were peri-implant probing depths (PPD), bleeding on probing (BOP) and marginal tissue height (MTH). Additionally, the presence of five putative periodontal pathogens were assessed using real-time polymerized chain reaction. At 12 months the overall implant survival rate was 95.8%. MBL change was not found to be different between test and control at any time points, but a significant change was detected within the test implants at 6 months compared to baseline (p = 0.006). No differences were found in the secondary outcomes. Average PPD at 12 months was 2.68 ± 0.73 mm and 2.30 ± 0.46 mm and average change in MTH was 0.05 ± 0.72 mm and −0.24 ± 0.59 mm at tests and controls. No differences were reported in BOP frequency. Total periodontal pathogens count revealed no significant difference among control, test implants and adjacent tooth sites. Within the limitations of this study, it can be concluded that the addition of PS to LM implants does not significantly alter either short-term clinical outcomes or the vulnerability to pathogenic microflora colonization.
Highlights
The results consistently reported a relative reduction in peri-implant probing depths (PPD)
To the authors’ best knowledge, this is the first randomized, pilot, study aimed at evaluating the microbiologic differences between these two types of implant characterized by an identical body design and surface, but a different platform width
No statistical differences were found in the abundance of periodontal pathogens between test, controls and adjacent teeth
Summary
Among the implant design alterations aiming to reduce marginal remodelling are platform switching (PS) [10] and laser micro-texturing (LM) [11] Both these technologies have shown promise in stabilisingperi-implant tissues. PS is a commonly used design to reduce marginal bone remodelling It involves a “mis-match” of the abutment platform to the underlying implant restorative platform, where the abutment platform is reduced in circumference. This design is thought to reduce the crestal bone remodelling through a manipulation of the biological width or by moving the “micro-gap” at the implant abutment interface. This hypothetical benefit was originally reported by Lazzara and Porter in
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