Accidental Discovery: Platform Switching

Have you heard the story behind platform switching?

More importantly, have you heard how platform switching has benefited implant patients?

Platform switching is a method used to preserve the alveolar bone levels around dental implants. The concept refers to placing restorative abutments of narrower diameters on implants of wider diameter, rather than placing abutments of similar diameters, referred to as platform matching.

Historically, the diameter of the abutment matched the diameter of the implant platform.
For example, a 4.8 mm-wide abutment was placed on a 4.8 mm-wide implant (Termedplatform-matching.)

Platform switching is when a narrower abutment diameter for a given implant platform diameter is used. For example, a 4.8 mm-wide implant may be restored with a 3.8 mm-wide or 4.2 mm-wide abutment.

Left: Regular abutment. Right: Smaller diameter abutment has accomplished a platform switch.

Discovered by accident in the late 1980’s, a situation was created in which mismatched standard-diameter abutments were used simply because of the lack of commercial availability of components to match the wide-diameter implants.

Surprisingly, it was found that these implants exhibited less than expected initial crestal bone loss during healing. Several early clinical reports demonstrated enhanced gingival and bone tissue responses to these platform switched implants. This has led to many implant companies incorporating platform switching into their implant systems even for narrower body implants.

Specific benefits of platform switching include:

  • Esthetics. If we can better preserve the crestal bone around an implant, then we can better preserve the gingiva as well. Healthy and plump gingiva, especially papilla, will give us a cosmetic advantage for the final restoration.
  • Implant Placement Flexibility. Traditionally implants had to be placed1.5 millimeters from a natural tooth, 3 millimeters from another implant, and 2 millimeters from thebuccal plate in order to compensate for the expected crestal bone loss. Platform switching preserves bone in all threedimensions: apical-coronal, buccal-lingual, and mesial-distal. This can give us more flexibility with our implant placement.

Bottom line, it works. Numerous studies and reviews have been published on platform switching that support these results. Further long-term studies and trials are needed to confirm the concept.