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Submitted by: Anonymous

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Platform switching is simply using an abutment that is smaller than the implant. Not all systems will allow you to do this. The reason that it is supposed to work is because it reduces the microgap, thus reducing bacterial induced bone loss. The goal of platform switching is to prevent the normal bone loss down to the first thread that occurs around most implants, thus enhancing soft tissue aesthetics and stability. One of the main causes of this bone-loss is the bacteria that lives in the micro-gap between the implant and the abutment and the inflammatory zone. Platform switching works by using smaller diameter abutments that move the micro-gap and inflammatory zone away from the bone, thus minimizing bone loss. Another method of platform switching and eliminating bone loss is the type of connection. Parallel or tapering implant-abutment interfaces such as Ankylos, Bicon, Astra were the first to do so in the 1980?s, and since the patent on that type of connection expired, Straumann and Nobel Biocare also have followed suit with tapering interfaces. Bry1143

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Submitted by: Anonymous

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Ok, I understand how platform switching works, but how reliable is it? isn't this supposed to rely on friction between the implant and the abutment? what about temperature fluctuations in the mouth when the patient drinks or eats something really hot or really cold? The implant itself is made out of a titanium alloy , whereas the abutment is not, so, the two materials expand/contract at different rates maybe making the concept unreliable? Ishai

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Submitted by: Anonymous

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I still wonder just how much of platform switching is science, and how much is marketing. I can't imagine the microgap being as much of an issue with modern implants. The manufacturing tolerances are so much more exacting than before, there is far less screw loosening, and many design improvements further helped to minimize potential gap problems.

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Submitted by: Anonymous

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Bicon is the only one that has an actual Morse taper connection of 1.5 degrees, and offers a higher degree of bacterial sealing, they also sometimes will allow bone growth over the actual top of the implant. Other Morse taper systems have various degrees of internal taper, which allow for the dissipations of oclusal and lateral forces, nearer to the apex of the implant,, avoiding bone less from stress at the implant platform area. The real strength of this concept lies in the fact that bacterial plaque has an adverse effect on gingival tissue up to a distance of 1.4 mm from its source. With platform switching, one distances the source of bacterial infection to the gingival tissue, allowing for a more healthy gingival tissue, preventing bone loss. One other important feature is the smaller diameter of the trans-gingival prosthetic connection in relation to the implant platform, allowing the gingival tissue to form thick and tight circular gingival fibers, which are the only type of fibers present around the transmucosal portion of dental implants.

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Submitted by: Anonymous

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There are many morse tapers with various degrees of taper which is not a strong connection. Ankylos also has a very strong and correctly angled morse taper which yields a very stable connection. Platform switching is where most companies are heading today and has a proven (20+) year history with very stable bone as a result. Also, one of the writers previously mentioned there isn't a problem with screw loosening and machining tolerances improving. In fact, the opposite is happening. Many lower cost alternatives are not fitting as well as should be expected resulting in micromovements and subsequent bone loss or screw loosening. If you look at the studies on micromovement, it is a concern for many people.

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