Nobel Biocare explains the principles of platform switching for successful dental implants
Platform switching, also known as platform shifting, is the term used in implantology whenever an abutment is used that is smaller in diameter than the implant platform. Platform switching can help prevent crestal bone loss, which is essential for the implant’s long-term success and stability. It can also increase the volume of soft tissue around the implant platform, which helps improve the aesthetic end result.
How platform switching works
Numerous factors can affect both bone loss and soft tissue health around an implant. A significant study relating to platform switching was conducted by Lazzara et al, in 2006. It describes how the concept was discovered accidentally over 25 years ago, when matching-diameter prosthetic components were not always commercially available and narrower ones were used instead. The study found, and hypothesised why, less crestal bone remodelling happens when smaller abutments are used on larger implant sites.
The theory is based on the biological width (the distance biologically needed between junctional epithelium and crestal bone, which is about 2 mm) deliberately creating through the platform switching a mesial component that means marginal bone will stay at an upper level. The advantages are discussed at length in the Lazzara text, and include the idea that any potentially damaging “inflammatory infiltrate”, material alien to the body’s cells, or present in excessive amounts, is moved away from the crestal bone.
Crestal bone preservation and platform switching
Well-proven benefits of platform switching on dental implants
Many studies around the topic have supported the theory that platform switching is a way to improve the preservation of crestal bone for greater implant stability. Other benefits include improved aesthetics, because preservation of crestal bone also benefits surrounding soft tissue. There is a wealth of recent work available that outline these positive benefits. One literature review found that “all papers show an improvement in peri-implant bone preservation and satisfactory aesthetic results”.
Embrace the philosophy: choosing the right component
When thinking about offering platform switching once you have built up your experience, it is important to choose the right component design.
A spokesperson from Nobel Biocare explains: “Nobel Biocare has helped drive the concept of platform switching forward with NobelReplace, a tapered implant that mimics the shape of a natural tooth root.
“Clinicians have experienced excellent aesthetics and good preservation in both soft tissue and crestal bone, with very good results at follow-up appointments. Alternatively, NobelParallel Conical Connection, also featuring platform switching, provides high primary stability and allows for universal use in all bone qualities and a wide range of indications.
“Nobel Biocare also provides high-quality training if this is an area where you would like to further develop your skills.”
He concludes: “Platform switching is both proven and popular. If you are thinking about improving your skill set and developing your experience in dental implantology, find out more about platform switching and how it would work for you and your patients.”
Image caption (top): Dental implants without (left) and with (right) platform switching