Should I platform switch dental implant abutments? This may have been somewhat of a controvery a decade ago but there is plenty of scientific data to support the efficacy and benefits at this point. A platform switch is using a smaller diameter abutment on a larger diameter implant platform. In addition to the aesthetic benefits discussed later, platform switching allows the patient to more effectively clean the dental implant site. A popular thought with the machine fit implants is that bugs/ bacteria are able to live right at the implant/abutment junction and prevent bone adaptation. The platform switch allows the junction to be more easily cleansed therefore allowing for better integration of bone in the area. Two additional benefits are:
- Better crestal bone response- It has long been accepted that an implant can cause up to 2mm of bone loss vertically and about 1.5 mm of loss horizontally. Platform switching has been shown to have approximately 20% less bone resorption at one year follow up and approximately .5mm greater crestal bone preservation at three years follow up. Greater bone loss can create an appearance of a gingival defect resulting in difficulty creating proper symmetry in the emergence of the final restoration.
- Better gingival emergence- As referenced above, emergence is critical in creating a natural looking crown. A smaller diameter abutment placed on an implant causes less impingement on the gingival tissue and better interproximal space between the adjacent teeth, this allows the technician more room to create a nice natural looking emergence of the restoration. This does not relieve the restoring dentist and laboratory from properly developing the tissue with a temporary.
Tip: I recommend this technique in the esthetic zone. (2nd bicuspid forward) While most manufacturers have made their systems compatible to platform switching make sure all parties are aware of it from the beginning. (Surgeon, dentist, and technician) This creates a perfect opportunity for communication between all parties.