Immediately loaded titanium implant with a tissue-stabilizing/maintaining design ('beyond platform switch') retrieved from man after 4 weeks: a histological and histomorphometrical evaluation. A case report.
ABSTRACT After implant insertion and loading, crestal bone usually undergoes remodeling and resorption. If the horizontal relationship between the outer edge of the implant and a smaller-diameter component ('platform switching') is altered, there seems to be reduced crestal bone loss. Immediate loading allows immediate restoration of esthetics and function, reduces morbidity, and facilitates functional rehabilitation.
Three Morse cone connection implants were inserted in the right posterior mandible in a 29-year-old partially edentulous patient. The platform of the implant was inserted 2 mm below the level of the alveolar crest. After a 1-month loading period, the most distal mandibular implant was retrieved with a trephine bur for psychological reasons.
At low-power magnification, it was possible to see that bone was present 2 mm above the level of the implant shoulder. No resorption of the coronal bone was present. No infrabony pockets were present. At the level of the shoulder of the implant, it was possible to observe the presence of dense connective tissue with only a few scattered inflammatory cells. Newly formed bone was found in direct contact with the implant surface. The bone-implant contact percentage was 65.3+/-4.8%.
Abutments smaller than the diameter of the implant body (platform switching) in combination with an absence of micromovement and microgap may protect the peri-implant soft and mineralized tissues, explaining the observed absence of bone resorption. Immediate loading did not interfere with bone formation and did not have adverse effects on osseointegration.
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ABSTRACT: The main objective of this study was to evaluate clinical and radiographic outcomes of implant-supported fixed partial prostheses, comparing platform switching and standard platform concepts. Patients with single or multiple partial edentulism were included in this prospective multicenter study. Success rate, as well as crestal bone loss and occurrence of complications were evaluated over time, for a minimum of 3 years after prosthesis delivery. Radiographic and clinical examination served to evaluate implant and prosthesis conditions. A total of 51 patients with 117 implants (55 in the centralized platform group and 62 in the standard platform group) were considered in the analysis. After 3 years of loading, the cumulative implant survival in test group was 90.3 %, while in the control group, it was 96.5 % without any statistically significant difference. After 3 years of function, the bone loss was 0.33 ± 0.19 mm in the test group and 0.48 ± 0.26 mm, revealing a significant difference. Platform switching concept may lead to a reduction of marginal bone loss over time if compared to standardized one. Such effect seemed not to be related to a reduction of overall success rate of the treatment. Platform switching could be a viable prosthetic option for implant treatment of partial edentulism.Clinical Oral Investigations 03/2015; DOI:10.1007/s00784-015-1462-z · 2.29 Impact Factor
Dataset: INGLES Livro IN 2013