Tomar Sidhartha, Saxena Deepesh, Kaur Navpreet
Assistant Professor, Subharti Dental College and Hospital, Swami Vivekanand Subharti University, Meerut, India.
Professor, Subharti Dental College and Hospital, Swami Vivekanand Subharti University, Meerut, India.
J Prosthet Dent. 2023 Oct 18. doi: 10.1016/j.prosdent.2023.09.009.
Platform switching using narrower abutments than the implant platform has been used to reduce marginal bone loss (MBL) surrounding dental implants. While platform switching has been reported to prevent initial peri-implant bone loss, available data regarding the use of the platform-switching implant abutment configuration with long-term follow-up has been sparse; thus, the systematic review was planned to evaluate the best available evidence for the use of the platform switching technique.
The purpose of this systematic review was to answer the specific question, "Is there a difference between platform-matching implant abutment configurations and platform-switching implant abutment configurations in terms of MBL changes around endosseous implants"?
The PubMed/Medline, Scopus, Google Scholar, and Lilac databases were searched by 2 independent reviewers for articles published between January 2000 and July 2022. Platform-switched versus platform-matched implants were examined for changes in MBL in human randomized clinical trials (RCTs) and potential clinically controlled cohort studies (PCCS).
Overall, 4 eligible studies were included and critically evaluated to summarize their findings. The follow-up period of the included studies was between 5 and 10 years. Two of the included studies showed a mean ±standard deviation of 0.6 ±0.20 mm MBL at 5 years and 1.20 ±0.21 mm at 10 years for the platform switched (PS) technique and 1.1 ±0.3 mm and 1.24 ±0.39 mm MBL for the platform matched (PM) technique. Another study showed marginal bone level changes for the platform-switched technique to be 0.18 ±0.14 mm as compared with the platform matched technique (0.80 ±0.40 mm). In one of the studies published in 2019, the mean estimated difference in the marginal bone levels of PS- and PM-restored implants after 5 years was reported to be 0.29 mm. The descriptive analysis of 4 RCTs indicated that platform-switched implant-to-abutment connections reduced average marginal bone loss surrounding implants compared with platform-matched implant-to-abutment connections, favoring the platform-switched approach.
Platform switching appears to be a beneficial approach for retaining the crestal bone around dental implants.
使用比种植体平台更窄的基台进行平台转换，已被用于减少牙种植体周围的边缘骨丢失（MBL）。虽然据报道平台转换可防止种植体周围初期骨丢失，但关于长期随访中使用平台转换种植体基台配置的数据却很稀少；因此，计划进行这项系统评价，以评估使用平台转换技术的最佳现有证据。
本系统评价的目的是回答具体问题：“在骨内种植体周围的MBL变化方面，平台匹配种植体基台配置与平台转换种植体基台配置之间是否存在差异？”
由2名独立评审人员在PubMed/Medline、Scopus、谷歌学术和Lilac数据库中检索2000年1月至2022年7月发表的文章。在人类随机临床试验（RCT）和潜在临床对照队列研究（PCCS）中，检查平台转换种植体与平台匹配种植体的MBL变化。
总体而言，纳入了4项符合条件的研究并进行严格评估，以总结其研究结果。纳入研究的随访期为5至10年。其中两项研究显示，对于平台转换（PS）技术，5年时MBL的平均值±标准差为0.6±0.20mm，10年时为1.20±0.21mm；对于平台匹配（PM）技术，MBL分别为1.1±0.3mm和1.24±0.39mm。另一项研究显示，与平台匹配技术（0.80±0.40mm）相比，平台转换技术的边缘骨水平变化为0.18±0.14mm。在2019年发表的一项研究中，据报道，5年后PS修复种植体和PM修复种植体边缘骨水平估计的平均差异为0.29mm。4项RCT的描述性分析表明，与平台匹配的种植体-基台连接相比，平台转换的种植体-基台连接减少了种植体周围的平均边缘骨丢失，支持平台转换方法。
平台转换似乎是保留牙种植体周围嵴骨的有益方法。
