peri implant bone level

J Oral Maxillo fac Surg 65:33-39, 2007, Suppl 1 Peri-Implant Bone Level Around Implants With Platform-Switched Abutments: Preliminary Data From a Prospective Study Markus Hürzeler, DMD, PhD,* Stefan Fickl, DMD,† Otto Zuhr, DMD,‡ and Hannes C. Wachtel, DMD, PhD§ Purpose: Several long-term clinical studies have shown a mean marginal bone loss around dental implants of 1.5 to 2 mm in the first year after prosth etic restor ation . Currently, conc epts to avoid bone remodeling around dental implants have been developed. The use of prosthetic abutments with reduced width in relation to the implant diameter (platform switching) seems to have the greatest potential to limit the crestal resorption. The purpose of this clinical trial was to show that crestal bone height around dental implants could be influenced using a platform switch protocol and that the bone level would remain stable within 1 year after final prosthetic reconstruction. Mater ials and Method s: Fifteen patients were treated with fixed implant retained prosthesis; 14 wide-diameter implants were supplied with platform-switched abutments and served as the test group. Eight implants with regul ar diameter were reconstructed with traditio nal abutment s and served as the control group. Standardized digital radiographs were obtained for evaluation of the peri-implant bone levels at the time of installation of the final restoration and at 1-year follow-up. Marginal p eri-implant bone levels were measured at the mesial and distal surfaces of each implant using digital image analysis. Results: The mean values of crestal bone height at baseline were 0.09 mm 0.65 mm for the platform-switched implants and 1.73 mm 0.46 mm for the nonplatform-switched implants. One year after final restoration, the mean value of crestal bone height was 0.22 mm 0.53 mm for the test group and 2.02 mm 0.49 mm for the control group. When tested with statistical means, the differences were significant for baseline and for follow-up ( P .0001). Mean bone level change from baseline to 1-year follow-up was 0.12 mm 0.40 mm for the test group and 0.29 mm 0.34 mm, respectively, for the control group. On analysis using ANCOVA, this difference was shown to be significant ( P .0132). Conclusion: The concep t of platfo rm swi tch ing appears to limit cre sta l res orp tio n and seems to preserve peri-implant bone levels. A certain amount of bone remodeling 1 year after final reconstruction occurs, but significant differences concerning the peri-implant bone height compared with the nonplatform-switched abutments are still evident 1 year after final restoration. The reduction of the abutment of 0.45 mm on each side (5 mm implant/4.1 mm abutment) seems sufficient to avoid peri-implant bone loss. © 2007 American Association of Oral and Maxillofacial Surgeons J Oral Maxillofac Surg 65:33-39, 2007, Suppl 1 Since the introduction of dental implants for the re- placement of missing teeth, treatment options for the partially or fully edentulous patient have expanded exponentially. Although different techniques and pro- cedures have been developed, postrestorative reduc- tions in per i-i mpl ant bon e hei ght have lon g bee n *Clinical Associate Professor, Department of Operative Dentistry and Periodontology, Albert Ludwigs University, Freiburg, Germany; Clinical Associate Professor, University of Texas, Dental Branch, Houston, TX; Private Practice, Private Institute for Periodontology and Implantology, Munich, Germany. †Priv ate Prac tice, Priv ate Insti tute for Perio dont olog y and Im- plantology, Munich, Germany. ‡Priv ate Prac tice, Priv ate Insti tute for Perio dont olog y and Im- plantology, Munich, Germany. §Clin ical Assoc iate Prof esso r, Depa rtment of Restorative Den- tistry, University School of Dental Medicine, Charite, Berlin, Ger- many ; Priv ate Prac tice, Priv ate Inst itut e for Peri odon tolo gy and Implantology, Munich, Germany. Add ress corr espo ndence and repr int requ ests to Pro f Hür zele r: Center for Dentistry, Peridontology and Implantology, Rosenkavalier- platz 18, Munich 81925, Germany; e-mail: [email protected] © 2007 American Association of Oral and Maxillofacial Surgeons 0278-2391/07/6507-0105$32.00/0 doi:10.1016/j.joms.2007.03.024 33

peri implant bone level

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