Platform Switching Research Articles

Effect of dental implant neck profile switching on crestal bone healing

Introduction: The majority of dental implants and prostheses rely on the association with the soft tissues that may be vulnerable to future requirements. There are two main requirements for osseointegration: first, the bone must be healthy; second, the implant must be stable and able to withstand the functional load. Methods and Results: Using both the computer12 model and finite element analysis technique to assess the bone space volume in implants with narrow-neck hybrid design compared with butt platform and bevel design at an inter-implant distance of 1 mm, the result showed approximately 56.7 mm in the butt joint platform design implant and between two bevel platforms (+2.74% or more), while it showed 78.42 mm (+38.32%) between two narrow-neck hybrid designs. Discussion and Conclusion: The implant platform switching technique is used to decrease the stress on the crestal bone and allow for better load distribution. This can be done at two levels: one is at the fixture–abutment interface, and the second within the bone at the fixture itself in the body–neck area. The narrow-neck hybrid design seems to be superior in lowering the stress on crestal bone and to provide more room for bone healing potential with less negative effect on soft tissue healing.

Impact of Two Implant-Abutment Connection Types on Crestal Bone Stability: A 3-Year Comparative Split-Mouth Clinical Trial.

This prospective, preliminary controlled clinical trial investigates the comparative effectiveness of platform-switching (PS) versus traditional butt-joint or platform-matching (PM) implant-abutment connections on peri-implant crestal bone stability. Utilizing a split mouth design, 10 systemically healthy patients (n= 20 implants) had adjacent non-restorable maxillary anterior teeth replaced with two different implants (butt-joint connections and platform-switching interfaces). Patients underwent alveolar ridge preservation, followed by implant placement: platform-matching implants were inserted at crestal bone level, and platform-switching implants were placed 1mm subcrestally. Customized Zirconia crowns were then fabricated for both systems. Outcome measures included bleeding on probing (BOP), probing pocket depth (PPD), and marginal bone loss (MBL), which were evaluated through standardized periapical radiographs over 3-year timeframe. Results showed significantly higher initial MBL in the PM group (0.86 ± 0.13 mm) compared to the PS group (0.34±0.29 mm) [p value: p<0.01]. Moreover, at the three-year follow-up, the crestal bone levels remained above the implant shoulder until the third year of the study for the PS subcrestal group (PS: -0.15±0.39 mm) and slightly below the implant platform in the PM crestal group (PM: 0.55±0.19). After 3 years, the PS group also exhibited lower mean BOP percentages (12%) than the butt-joint group (17%). This study suggests that subcrestal placement with PS and internal connections can provide better long-term peri- implant bone preservation, thereby potentially improving implant success and aesthetic outcomes in the anterior maxillary region.

Immediate Insertion and Restoration of a Single Implant to Replace Two Adjacent Periodontally Compromised Lower Incisors: A Technique Report with up-to-8 Years Follow-up.

The study investigated the cumulative survival rate (CSR) and marginal bone loss (MBL) of single implants immediately placed and restored with two-unit cantilevered fixed dental prostheses after extraction of two adjacent mandibular incisors with a compromised periodontal condition. Patients in need of extraction and replacement of two adjacent mandibular incisors due to advanced periodontal loss of attachment were treated consecutively. Following a flapless procedure, a single implant was inserted at the time of extraction in one of the two fresh alveoli sockets and immediately restored with a screw retained two-unit provisional FDP. The area of extraction was grafted using xenograft particulate material. Peri-implant soft tissue and hard tissue condition at the last follow-up appointment, marginal bone loss at the last follow-up appointment at least 1 year after the delivery of the final prosthesis, and the final aesthetic result were evaluated. Twenty patients were recruited between January 2014 and December 2019 in a single private practice and each received single implants and immediate provisional restoration with a two-unit cantilevered fixed dental prosthesis. Patients were followed for 22 to 94 months (average follow-up &#61; 4 years) and none of the implants failed resulting in 100% CSR. Cumulative MBL -measured using the VixWin Platinum software -was 1.08 &#43;/- 0.35. A lower MBL was observed in the presence of platform switching (0.63 &#43;/- 0.11 mm) compared to the absence of platform switching (1.27 &#43;/- 0.20 mm). The preliminary results obtained from this study suggest that patients in need of replacing two adjacent periodontally compromised mandibular incisors can be treated with an immediately inserted and restored single implant.

Analysis of 8.5 mm Long Dental Implants Provided with Splinted or Solitary Implant Restorations: A 15-Year Prospective Study.

Background/Objectives: The long-term effects of implant properties, such as implant length, platform switch, and crown splinting, on peri-implant health require more investigation. Therefore, the aim was to assess the long-term peri-implant health and patient satisfaction in a patient cohort, obtained from two prospective randomized controlled trials, who received 8.5 mm long dental implants, with either splinted or solitary suprastructures and with or without a platform switch, over a period of 15 years. Methods: One hundred and twenty-two patients received either one or two 8.5 mm long dental implants (223 dental implants) with and without platform switch, restored with either a solitary (n = 89) or a splinted (n = 134) restoration in the posterior region. Clinical and radiographical parameters and patient satisfaction were prospectively recorded at 1 month, and 1, 5, and 15 years after the placement of the restoration. Patient satisfaction was recorded with a self-administered questionnaire using a 5-point scale and a visual analog scale (0-10). Results: Eighty-one patients with one hundred and fifty-four implants were assessed after a 15-year follow-up. The clinical parameters were low and comparable between the implant types (OsseoTite XP Certain, OsseoTite XP Certain Prevail, NanoTite XP Certain, NanoTite XP Certain Prevail, PalmBeach Gardens, FL, USA) over time. The implants that incorporated a platform switch showed significantly less bone loss than the implants without a platform switch (-0.37 mm, 95% CI -0.69 to -0.05 mm, p = 0.024 and β = -0.47, 95% CI -0.80 to -0.14, p = 0.006). The implants with splinted restorations experienced more bone loss over time compared to the implants with solitary restorations (0.39 mm, 95% CI 0.15-0.63, p = 0.002). Patient satisfaction was high after 15 years. Conclusions: All the tested dental implants with 8.5 mm length provide satisfactory 15-year results with regard to the clinical and radiographical parameters as well as patient satisfaction. The platform-matched implants were associated with more bone loss compared to the platform-switched implants, and the implants with splinted crowns portrayed more bone loss than the solitary implant crowns.

Survey of screw-retained versus cement-retained implant restorations used in both education and private dental practices.

In the literature, it is still unclear if the decisions for selecting the type of implant crown-retaining system are based on scientific-based research or if the Universities' choices, Implant marketing trends, or finances could have a major influence on the private dentists' decisions. Therefore, this study aimed to evaluate the crown-retaining system (cement- or screw-retained) used in dental schools and private dental practices. A 13-item questionnaire was sent to Canadian dental schools (n=10) and dental offices in London (n=298), Canada. The questionnaire included demographic questions and questions to reveal the dentists' perspectives on prosthetic implant treatment between the two-retaining systems. Results were analyzed using descriptive statistics and multinomial logistic regression (p=0.05). Twenty-four private dentists and five dental schools responded to the survey - 62.5% of private practitioners and 60% of universities reported using both systems. A trend was observed in using screw-retained systems by dentists who graduated 5-10 years ago. Straumann, Astra, and Nobel Biocare were the private practices and dental schools' preferred implant systems. The use of platform switching for all cases was selected by 54.2% of the private practitioners and 40% of the dental schools. Resin cement was the private practice's preferred cementation method; the dental schools used glass ionomer and zinc phosphate cement. The multinomial logistic regressions showed no statistical difference between the crown-retaining system chosen and the decision factors. The laboratory technician's recommendations and cost influenced the decision-making process for private dentists. For the universities, perio-restorative outcome, implant position, survival rates, institute preferences, and evidence-based research influenced the crown-retaining system's decision-making process. CONCLUSION: The Canadian dental schools and private practice reported using both screw- and cement-retaining systems. However, there was a difference in the selection criteria as the universities showed a tendency towards a more research-based approach in their decision, while for the private practices, the technicians' recommendations and cost played a major role in the decision process. It was noted that the implant systems preconized by the Universities were observed to be used in private practices.

The past forty-three years of dental implantology literature. A global mapping and scientometric analysis

PurposeThe aim of this research is to make a scientometric analysis of the dental implantology literature and to present the results in a more understandable way to the reader by visualizing them with maps. MethodsThe dental implantology literature was accessed through the Web of Science database. Scientometric data was obtained with Citespace 6.1 software, co-citation, clustering analysis, citation burst, and mapping analyzes were performed. Scimago Graphica software was used for additional visualizations. ResultsA total of 35,704 articles were included in the analysis. There were 88,616 authors, 72,333 institutes, 142 countries/regions, and 3,265 journals contributing to the dental implantology literature. The United States was first with 7,334 publications and 225,868 citations. The literature between 1980 and 2023 was divided into 19 different clusters, and the literature between 2000 and 2023 was divided into 16 different clusters. ConclusionsKey themes in the field include the use of autogenous bone, advancements in implant surface technology, and the use of platform switching and intraoral scanners. Emerging topics of interest include esthetic considerations in the treatment of the anterior region, stress distribution, the use of zirconia, and the impact of implant treatment on oral health-related quality of life. With similar scientometric analysis studies to be done in the future, the progress of the literature can be followed on the basis of evidence.

Evaluation of the Differences in the Stability of Alveolar Bone around Dental Implant and Implant Failure between Platform Matching and Platform Switching: A Systematic Review and Meta-Analysis

Evaluation of the Differences in the Stability of Alveolar Bone around Dental Implant and Implant Failure between Platform Matching and Platform Switching: A Systematic Review and Meta-Analysis

An introduction to dental implants.

The use of implants to replace missing teeth is now commonplace and practised by clinicians worldwide in both general and specialist practice. There is an abundance of evidence on the general success of implant treatment. As well as reviewing the history of dental implants, this narrative review will discuss the merits and successful placement of tissue-level verses bone-level implants. Furthermore, the article will evaluate the concept and benefits of platform switching for implant treatment. Finally, with the increased placement of implants, this narrative paper will review how different titanium surfaces impact on the risk of peri-implantitis.

New Radiological Corticalization Index as an Indicator of Implant Success Rate Depending on Prosthetic Restoration-5 Years of Follow-Up.

The new Radiological Corticalization Index (CI) is an indicator that describes bone remodeling near the dental implant's neck at the pixel level and is not visible to the naked eye. The aim of this research was to evaluate the correlation between the CI and bone remodeling using only radiographic (RTG) images. RTG samples were divided into groups depending on prosthetic restoration; the implant neck area around dental implants was examined, and texture features of the RTG images were analyzed. The study also investigated the type of prosthetic restoration and its influence as a factor on bone structure. The statistical analysis included evaluating feature distribution, comparing means (t-test) or medians (W-test), and performing a regression analysis and one-way analysis of variance or the Kruskal-Wallis test, as no normal distribution or between-group variance was indicated for the significant differences in the investigated groups. Differences or relationships were considered statistically significant at p < 0.05. The research revealed correlations between single crowns, overdenture restoration, bridge restoration, platform switching, prosthetic fracture, CI, and also marginal bone loss where p was lower than 0.05. However, the corticalization phenomenon itself has not yet been fully explored. The findings suggest that, depending on the type of prosthetic restoration, the corticalization index may correlate with marginal bone loss or not. Further research is necessary, as the index is suspected to not be homogeneous.

Multivariate analysis of the effect of keratinized mucosa on peri-implant tissues with platform switching: A retrospective study.

In recent years, platform switching implant treatment has been increasing, which is believed to minimize bone loss around the implant after placement. However, there have been no reports on the relationship between keratinized mucosa width (KMW) and bone loss and soft tissue recession in platform switching implants. We evaluated the effect of the KMW on the amount of bone loss and soft tissue recession around a platform switching implant retrospectively using multivariate analysis. This one-year retrospective study included 91 implants in 48 patients. Age, sex, a history of periodontitis, implant location, oral hygiene status, and the KMW were included as explanatory variables to evaluate bone loss (BL) and buccal gingival height (GH). Generalized estimating equations (GEEs) were used to evaluate the effect of the KMW on platform switching peri-implant tissues. The mean bone loss on the mesial (ΔBLm), distal (ΔBLd), and buccal (ΔBLb) sides of the implant were 0.16 ± 0.27 mm, 0.19 ± 0.34 mm, and 0.24 ± 0.50 mm, respectively, at 1 year after superstructure placement. The mean amount of change of GH (ΔGH) on the buccal side was 0.30 ± 0.47 mm. After correcting for confounders using GEEs, the results suggested that KMW <1.5 mm was a significant factor (P < 0.001) for bone loss over time in ΔBLm, ΔBLd, and ΔBLb. In addition, for soft tissues on the buccal side, KMW <1.5 mm was a significant factor for ΔGH reduction over time (P < 0.001). Keratinized mucosa width ≥1.5 mm was associated with a higher probability less hard and soft tissue recession around the platform switching implant after 1 year from superstructure placement.

Innovation, Competitive Advantage, and Customer Loyalty: Insights from Live Streaming Enterprises

With the rapid development of e-commerce, giants like Baidu, Alibaba, and Tencent have ventured into the live streaming industry, leading to intense competition among numerous live e-commerce platforms and posing challenges related to customer retention. Despite platforms offering promotional activities, consumers' curiosity often leads to frequent platform switching. Furthermore, there has been a continuous increase in e-commerce complaints, especially in the live e-commerce sector, with issues related to logistics, product quality, returns, and exchanges affecting the overall shopping experience. Additionally, the lack of brand differentiation among platforms has contributed to decreased customer loyalty. This study investigates the relationship between innovation capability, competitive advantage, and customer loyalty in live streaming businesses, utilizing 576 valid questionnaires and structural equation modeling for analysis. The results reveal that innovation capability has a positive impact on both customer loyalty and competitive advantage. Competitive advantage also positively influences customer loyalty and serves as a partial mediator between innovation capability and customer loyalty.

Evaluation of stress distribution in and around dental implants using three different implant-abutment interfaces with platform-switched and non-platform-switched abutments: A three-dimensional finite element analysis.

A key factor for the success or failure of an implant is how the stresses are transferred to the surrounding bone. The implant‒abutment connection (IAC) is paramount for implant success. The purpose of this finite element analysis (FEA) study was to evaluate the stress distribution in and around three different implant‒abutment interfaces with platform-switched and platform-matched abutments using the finite element method (FEM). Three distinct types of IAC were selected: tri-channel internal connection, conical connection, and internal hex connection. Six models were generated, three in platform-switched and three in non-platform-switched configuration. Computer-Aided Three-Dimensional Interactive Application (CATIA) V5 R20 software was used to generate virtual models of the implants and the mandible. The models were transferred to Analysis of Systems (ANSYS) 15.0 software, in which the models were meshed and underwent FEA. On the crestal bone, the highest von Mises stresses in platform-switched abutments were noticed in the internal hex implant‒abutment system (370 MPa), followed by the tri-channel implant‒abutment system (190 MPa) and conical implant‒abutment system (110 MPa). On the implant and the abutment screw, the highest von Mises stresses were observed in the internal hex implant‒abutment system, followed by the conical implant abutment system and tri-channel implant‒abutment system. Platform-switched implants had a more favorable stress distribution on crestal bone. Within the constraints of the current study, the internal hex connection exhibited the highest stress. In contrast, the conical abutment connection with platform switching configuration had more favorable stress distribution in crestal bone than other implant abutment systems.

Comparison of values of crestal bone loss around dental implants: A comparative study

Introduction: Many studies have examined values of crestal bone loss according surgical techniques, time of implant placement (immediate post-extraction or after alveolar socket healing), platform switching or convectional platform, surface of the implant, functional loading (immediate or delayed), etc. Methods: This study analyzed a total of 443 dental implants on 115 images: 161 Bredent blueSKY dental implants and 282 Ritter spiral dental implants. All images were taken at the Faculty of Dentistry of the University of Sarajevo: before implantation and after 1 year of functional loading. Crestal bone loss was measured on the mesial and distal side of each implant from the coronal portion of the abutment to the noticeable margin of the alveolar bone. Results: There is statistically significant differences between Bredent blueSKY and Ritter spiral dental implants regarding mesial (p &lt; 0.001, df = 441, tstat = −64.22) and distal (p &lt; 0.001, df = 441, tstat = −151.21) bone losses. Conclusion: Platform switching dental implants showed more bone loss on the mesial and distal side of implant than dental implants with conventional platform.

Computational modelling and analysis of hard tissue behavior around 0.5 mm and 0.85 mm platform switched abutment using 3D finite element analysis

Permanent tooth avulsion is a common but extremely serious dental injury that can negatively affect both economic output and lifestyle. Even though it is not a disease, no one is ever completely safe from the possibility of suffering from these disastrous injuries. Dental implants play a vital role in the treatment of such injuries (tooth loss). This work was focused on to find the effects of two different platform switched abutment-implant assembly on hard tissues (Cortical and cancellous) bone. Materialized Mimics Medical Software was used for processing clinical imaging (CBCT) data of mandibular bone and micro-CT data of implant (5.5 × 9.5 mm), Abutments (Pt. sw. I and Pt. sw. II) and final 3D model of all parts were obtained by Fusion 360 CAD software and implanted into a right mandible bone block. Implant-Abutment with different switching assembly as platform switched-I (Pt. Sw. I) Ø5.5-mm implant and Ø3.8-mm abutment and the platform switched-II (Pt. Sw. II) Ø5.5-mm implant and Ø4.5-mm abutment were compared. Each model was subjected to 50 N, 100 N and 150 N longitudinal and lateral loads at occlusal surface of the abutment to evaluate the mechanical parameters. ANSYS 2020R1 was used to conduct the computational analysis. Mechanical characteristics such as von-Mises stresses and total deformation were measured in the hard tissues using finite element modelling. Under the application of different loads the cancellous bone experiences maximum von misses stress 4.7 MPa and 5.4 MPa for Pt. Sw. I and Pt. Sw. II respectively under longitudinal load and 7.4 MPa and 8.7 MPa for Pt. Sw. I and Pt. Sw. II respectively under lateral load. Similar trends were observed for cortical bone. While maximum total deformation of 2.1 µm (Pt. Sw. I) and 2.2 µm (Pt. Sw. II) under longitudinal load and 4.4 µm and 4.6 µm in cancellous bone and cortical bone under longitudinal load and 4.4 µm (Pt. Sw. I) and 4.6 µm (Pt. Sw. II) under lateral load in cancellous and 7.5 µm (Pt. Sw. I) and 8 µm (Pt. Sw. II) in cortical bone were recorded. The analysis may help to prevent the progression of marginal bone loss (MBL) because lower results for these variables indicated for higher platform switching in marginal bone. The findings of computational frameworks can help clinicians and other medical professionals make more informed decisions when selecting a treatment strategy from the many options available.

Evaluation of Stress Distribution in Platform Switch Short Dental Placed at Different Depths in D1 bone – An in Vitro 3D FEM Study

Context: FEA has been extensively used in implant dentistry to predict the biomechanical behavior of various dental implant designs, as well as the effect of clinical factors for predicting clinical success. Stress patterns in implant components and surrounding bone are well studied. Objective: To investigate the pattern of stress distribution in terms of equicrestal and subcrestal implant placement at various depths using short platform switching dental implants. Materials and Methods: 3D FEM of the mandibular anterior area was modelled with a uniformly cortical bone of 0.5 mm with an inner core of cancellous bone (FEM) using ANYSIS soft wear. Four implant modes were used with the following dimensions. Model 1. (6x4.6x3.5mm), models 2 (7.5x4.6x3.5mm), 3 (6x5.8x4.5mm), and 4 (7.5x5.8x4.5mm). For a realistic simulation, 100N and 200N of force were applied in axial and oblique directions (0°, 15°, and 30°, respectively). At different depths, both cancellous and cortical bone is evaluated for von Mises stress. Ten-noded tetrahedron components with three degrees of freedom per node are used to interpret translations on the x, y, and z axes. Results: Based on bone shape, force direction, and depth of implant placement, each of the five positions of platform-switched short osseointegrated implants examined by FEM simulations had a unique stress-based biomechanical behavior. Conclusions: Axial forces were less harmful than oblique forces. The cortical and cancellous bone experienced less stress because of the implantation of subcrestal implants. According to recent research, platform-switched short subcrestal implant models result in improved stress distribution around peri implant areas in D1 bone and the conservation of marginal bone loss.

Investigating the impact of diameters and thread designs on the Biomechanics of short implants placed in D4 bone: a 3D finite element analysis

BackgroundDental implants emerge as a dependable and efficacious alternative for patients experiencing partial or complete tooth loss. The stability of these implants is influenced by surface topography and macro-level design. In cases where the height of the maxillary posterior region is diminished, employing short implants can prove advantageous. With the aim of examining the distribution of von Mises stress, strain, and micromovement in D4 bone quality surrounding platform-switched short implants, measuring 6 mm in length and featuring diameters ranging from 4 to 6 mm, as well as different thread designs, an in-depth finite element analysis was conducted under immediate loading conditions. MethodologyA 3D finite element model was constructed to simulate maxillary molar crowns, incorporating an implant with a length of 6 mm and varying diameters and thread designs. The diameters utilized were 4/3.6 mm, 5/4 mm, and 6/4.8 mm, while the thread designs included buttress, square, and triangle patterns. Each model underwent analysis with a 100 N force applied in two directions: vertical and oblique, relative to the long axis of the implant. Stress, strain, and micromovement in the peri-implant region were recorded, employing the Ansys Workbench R v.18.1 software for modelling and analysis.ResultsWhen comparing all three diameters, the wide diameter (6 mm threads) exhibited the lowest values of peri-implant von Mises stresses (3.3 MPa and 35.1 MPa), strains (194 Ɛ and 484 Ɛ), and micromovements (0.7 μm and 1.3 Ɛ) subjected to axial and non-axial loading of a 100 N force. Notably, square microthreads yielded the most favorable stress parameters among the different thread shapes, manifesting the minimum values of stress, strains, and micromovements in their vicinity.ConclusionFor the treatment of atrophic ridges or in scenarios necessitating extensive surgical preparation of the implant site, a combination of short implants, wide diameters, and platform switching can be employed. In situations with reduced bone height and the requirement for an implant-supported prosthesis to replace a missing permanent maxillary molar, the utilization of wide-diameter platform-switched short implants measuring 6 mm in length, featuring a square thread design, should be taken into consideration.

Impact of Implant Diameter on Success and Survival of Dental Implants: An Observational Cohort Study

Narrow-diameter implants (NDIs) can be inserted instead of standard dental implants (SDIs) in sites with limited space and bone availability. The aim of this study was to evaluate the effect of implant diameter on peri-implant bone, attached mucosa, and on the associated probability of implant success and survival. The implants with progressive thread design and platform switching (Ankylos®, Dentsply Sirona; Mannheim, Germany) investigated were identified retrospectively and assigned to two groups based on their diameter: 3.5 mm (NDIs) and 4.5 mm (SDIs). Peri-implant bone loss was analyzed based on available radiographs. Descriptive and implant-associated factors were gathered from patient files. Data were statistically analyzed using the Kolmogorov–Smirnov–Lilliefors test and regression analyses. The level of significance was p ≤ 0.05. Results: In total, data for 415 implants in 194 patients were included in the study. Ten-year survival was 95.8% (NDIs) and 91.1% (SDIs). Implant diameter had no significant effect on peri-implant crestal bone loss (p = 0.098) or on the width of the attached gingiva (p = 0.052). Survival and success rates of NDIs were like or slightly better than those of SDIs. Because implant diameter had no effect on peri-implant tissue, NDIs can be recommended in selected cases.

Clinical and Radiographic Outcomes of a New Fully Tapered Implant with the One-Abutment One-Time Approach: In-Line Clinical Case Series with a 1-Year Follow-up.

To evaluate the bone level changes in a new implant design (fully tapered with platform switching) with the one-abutment one-time protocol after 1 year of loading. Thirty patients received 1 or 2 implants (6-, 8-, or 10-mm length and 3.5-, 3.75-, or 4.5-mm diameter, bone-level design) to replace one or multiple edentulous sites. Only the mesial implant was assessed. Radiographic, clinical, and esthetic results and the survival and success rates were evaluated 1 year after final loading. At 1 year, no peri-implant bone loss was seen in any of the cases. Mean marginal crestal bone loss between surgery and crown placement was 0.19 ± 0.17 mm (P < .0001). Between surgery and the 1-year follow-up, the mean marginal crestal bone loss was 0.25 ± 0.24 mm (P < .0001). The difference in the modified Plaque Index between 1 year of follow-up and crown placement was significant for in the mesial (0.33 ± 0.54 mm; P = .003) and distal surfaces (0.5 ± 0.73 mm; P = .001). The probing pocket depth was statistically significantly deeper at 1 year than at crown placement at the mesial and distal aspects (average depth = 0.75 mm; P < .0005). No statistically significant differences were found for any other clinical or esthetic parameters. The overall survival and success rates after 1 year were 100%. The fully tapered, deep-thread, platform-switched implant design placed with the one-abutment one-time protocol demonstrated minimal marginal crestal bone loss and crestal bone stability at 1 year of follow-up.

Can patients detect peri‑implant mucosal inflammation? Results from a multicentre randomized trial

PurposeThe objective of this study was to compare patient-reported outcomes (PROs) of peri‑implant soft tissue inflammation and aesthetics around single-tooth implants in the anterior maxillary region with three different implant-abutment interface designs. MethodsParticipants were randomized to one of three different types of implant-abutment interface designs [Conical (CI), flat-to-flat (FI), and Platform Switched (PS)]. Implants and provisional crowns with prefabricated titanium abutments were placed 5 months following extraction and/or ridge augmentation. Permanent ceramic crowns with zirconia abutments were placed after 12 weeks. To assess PROs, appearance and inflammation questionnaires were completed from provisional crown placement to the 3-year follow-up. ResultsTooth appearance at the 3-year follow-up revealed a difference amongst CI, FI and PS implants (p=0.049; Kruskal-Wallis test). PS was rated better than FI (p=0.047) at 1 year for appearance of soft-tissue and satisfaction with colour. There were no differences for self-consciousness, smile and pain/discomfort while eating/hard food items. ConclusionsAlthough participants tended to rate the health of mucosa around PS implants as slighty better than the other two implant systems, the differences were minimal and inconsistent. Thus, patient satisfaction in terms self-perceived gingival health and esthetics was high for all 3 systems tested, suggesting that patients are unable to detect mucosal inflammation. Clinical SignificancePatients find it difficult to perceive mucosal inflammation; hence, it is recommended that patients attend implant follow-up visits, even if they do not perceive inflammation. The study suggests that there is a relationship between the PROs and the clinical outcomes of tested implants.

In Silico Mechanical Effort Analysis of the All-On-4 Design Performed with Platform-Switching Distal Short Dental Implants.

This study evaluated the mechanical behavior of the All-on-4 concept performed with short-length distal implants with platform-switching (PSW) connection by using finite element analysis (FEA). Three models of the All-on-4 configuration were generated in human atrophic mandibles. The models consisted of tilted standard (AO4T; θ = 30°; 11 mm-length), straight standard (AO4S; θ = 0°; 11 mm-length) and straight short (AO4Sh; θ = 0°; 8 mm-length) distal implants. A resultant force of 300 N was performed obliquely in the left side and posterior region of the prosthetic bar. The von Mises equivalent stress (svm) and maximum and minimum principal stresses (smax and smin) were performed at the level of the prosthetic components/implants and peri-implant bone crest, respectively. The AO4S configuration showed the lowest values of svm in the ML and DL abutments (37.53 MPa and 232.77 MPa, respectively) and dental implants (91.53 MPa and 231.21 MPa, respectively). The highest values of smax and smin were noticed in the peri-implant bone crest of the AO4T design. All models presented lower odds of technical failures. The highest odds of peri-implant bone overload may occur when the All-on-4 concept is performed with standard-length 30o-angled distal implants with PSW connection.