Platform switching in two-implant bar-retained mandibular overdentures: 1-year results from a split-mouth randomized controlled clinical trial.

Abou-Ayash, Samir; Schimmel, Martin; Kraus, Dominik; Mericske-Stern, Regina; Albrecht, Dominic; Enkling, Norbert (2020). Platform switching in two-implant bar-retained mandibular overdentures: 1-year results from a split-mouth randomized controlled clinical trial. Clinical oral implants research, 31(10), pp. 968-979. Wiley-Blackwell 10.1111/clr.13640

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OBJECTIVES

The concept of platform switching is widely applied in current implant dentistry, however, the influence on peri-implant bone level alterations (ΔIBL), especially in the field of implant overdentures (IODs), remains inconclusive. Therefore, the present study aimed to test the alternative hypothesis that there is an equivalent ΔIBL at platform-switching and platform-matching implant abutments in 2-implant bar-retained IODs.

MATERIALS AND METHODS

Two interforaminal implants were placed in 32 subjects, who were randomly assigned to either an immediate- or a 3-month post-placement loading group. Furthermore, one implant in each subject was randomly assigned to receive a platform-switched (test), and one a platform-matching abutment (control). The implants were splinted with prefabricated, chairside customized bars. ΔIBL was recorded by using customized radiograph holders at implant placement, implant loading, 3 months, 6 months, and 12 months after loading.

RESULTS

After one year, equivalent ΔIBL could be identified (test: -0.51 mm +/- 0.49 vs. control: -0.56 mm +/- 0.52; p<0.001). ΔIBL increased over time and was more pronounced in the delayed-loaded (-0.87 mm +/- 0.61) relative to the immediately loaded implants (-0.35 mm +/- 0.43; p = 0.022).

CONCLUSIONS

The prosthetic concept of platform switching does not necessarily lead to reduced bone loss. Immediate loading of implants, primarily splinted with a bar, might be beneficial regarding peri-implant bone-level changes over a short-term period.

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