Peri-implant marginal bone level: a systematic review and meta-analysis of studies comparing platform switching versus conventionally restored implants

J Clin Periodontol. 2012 Nov;39(11):1097-113. doi: 10.1111/j.1600-051X.2012.01930.x. Epub 2012 Aug 29.

Abstract

Aim: To systematically review the literature to compare implant survival (IS) and marginal bone loss (MBL) around platform-switched (PS) versus conventionally restored platform-matching dental implants.

Material and methods: Randomized, controlled human clinical trials (RCTs) comparing IS and MBL in PS and conventionally restored implants, with 12 months of follow-up and at least 10 implants were identified through electronic and manual search. Review and meta-analysis were performed according to PRISMA statement. Risk ratio (RR) for implant failure and mean difference (MD) for MBL, with 95% confidence interval (CI) were calculated. Sources of heterogeneity among studies were also investigated by subgroup analyses.

Results: Ten RCTs involving 435 subjects and 993 implants contributed to this review. The cumulative estimated implant success rate revealed no statistically significant difference between the two groups. At a patient level, a smaller amount of MBL [MD -0.55 mm, 95%CI (-0.86; -0.24), p = 0.0006] was noted around PS implants. Subgroup analyses performed at implant level suggested less MBL when platform switching showed a larger mismatching.

Conclusion: PS technique appeared to be useful in limiting bone resorption. Nevertheless, these data should be interpreted cautiously as significant heterogeneity and possible publication bias were noted. Further research is needed to identify the factors most associated with successful outcomes.

Publication types

  • Comparative Study
  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • Alveolar Bone Loss / etiology*
  • Alveolar Process / surgery
  • Bone Resorption / etiology*
  • Dental Implant-Abutment Design / adverse effects*
  • Dental Implantation, Endosseous / adverse effects*
  • Dental Implantation, Endosseous / methods
  • Dental Implants / adverse effects
  • Dental Prosthesis Design
  • Dental Prosthesis Retention / adverse effects
  • Dental Prosthesis Retention / instrumentation
  • Dental Prosthesis, Implant-Supported / adverse effects*
  • Dental Prosthesis, Implant-Supported / instrumentation
  • Humans

Substances

  • Dental Implants