Abstract
Data sources
MEDLINE, EMBASE, The Cochrane Oral Health Group's Trials Register, The Cochrane Central Register of Controlled Trials (CENTRAL), UK National Research Register, Australian New Zealand Clinical Trials Registry (ANZCTR), Database of Abstracts of Reviews of Effectiveness (DARE), ISI Proceedings for relevant conference abstracts. The search strategy used keywords but not subject heading terms. A number of relevant journals were hand searched (seven most recent years) and authors were contacted in the absence of complete data.
Study selection
Randomised controlled trials (RCT) or controlled clinical trials (CCT) reported in English only, that compared platform-switched to platform-matched implants were eligible. A minimum of 10 implants had to have been placed in the platform-switched group (it is unclear if there was a minimum for the comparison group) and they had to have been followed up for a minimum of 12 months. Primary outcome was marginal bone level changes. Secondary outcome was implant failure rate.
Data extraction and synthesis
Data were extracted by more than one author using a data extraction form. Quality assessment was done using the Jadad scale. Meta-analysis was conducted using fixed effects model in the absence of significant heterogeneity, and the random effects model where heterogeneity was greater. Statistical heterogeneity was assessed using the chi2 and I2 tests. Sensitivity and subgroup analyses were planned to identify any potential causes of heterogeneity.
Results
Ten studies including 1239 implants were included and all were published 2007-2010. Seven were RCTs, three were CCTs. Range of observation was 12-60 months. Methodological quality was assessed as ‘satisfactory’. Chi2 =126.79 (P <0.0001), I2 = 91% indicating significant statistical heterogeneity. Thus the random effects model was used to synthesise the data. Bone loss in the platform-matched implant group was greater with a mean difference of −0.37 mm (95% CI −0.55 to −0.20, P <0.0001). This is based on the longest follow-up interval from each trial (therefore could be anywhere between 12 and 60 months). There was no significant difference in implant failure.
Conclusions
Platform-switching may preserve vertical crestal bone levels more than platform-matching when placing implants.
Similar content being viewed by others
Log in or create a free account to read this content
Gain free access to this article, as well as selected content from this journal and more on nature.com
or
References
Albrektsson T, Zarb G, Worthington P, Eriksson AR . The long-term efficacy of currently used dental implants: a review and proposed criteria of success. Int J Oral Maxillofac Implants 1986; 1: 11–25.
Prasad DK, Shetty M, Bansal N, Hegde C . Crestal bone preservation: a review of different approaches for successful implant therapy. Indian J Dent Res 2011; 22:317–323.
Lazzara RJ, Porter SS . Platform switching: a new concept in implant dentistry for controlling postrestorative crestal bone levels. Int J Periodontics Restorative Dent 2006; 26:9–17.
Liberati A, Altman DG, Tetzlaff J, et al. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: explanation and elaboration. Br Med J 2009; 339: b2700 doi: 10.1136/bmj.b2700.
Higgins J, Green S (eds). Cochrane handbook for systematic reviews of interventions. Wiley 2011.
Misch, CE . Dental Implant Prosthetics. 1e. Mosby; 2004.
Al-Nsour MM, Chan HL, Wang HL . Effect of the platform-switching technique on preservation of peri-implant marginal bone: a systematic review. Int J Oral Maxillofac Implants 2012; 27: 138–145.
Author information
Authors and Affiliations
Additional information
Address for correspondence: Sir John Walsh Research Institute, School of Dentistry, University of Otago, Dunedin, New Zealand. E-mail: maatieh@gmail.com
Atieh MA, Ibrahim HM, Atieh AH. Platform switching for marginal bone preservation around dental implants: a systematic review and meta-analysis. J Periodontol 2010; 81: 1350–1366.
Rights and permissions
About this article
Cite this article
Stafford, G. Evidence supporting platform-switching to preserve marginal bone levels not definitive. Evid Based Dent 13, 56–57 (2012). https://doi.org/10.1038/sj.ebd.6400864
Published:
Issue date:
DOI: https://doi.org/10.1038/sj.ebd.6400864
This article is cited by
-
Platform switching of implants may decrease bone loss
Evidence-Based Dentistry (2015)
