Impact of platform switching implants on crestal bone level: A systematic review and meta-analysis

Abstract

STATEMENT OF PROBLEM: Despite the widespread success of dental implants, crestal bone loss (CBL) remains a significant challenge, compromising long-term stability and esthetics. PURPOSE: The purpose of this systematic review and meta-analysis was to evaluate the effectiveness of platform switching in reducing CBL compared with conventional implant designs. MATERIAL AND METHODS: This systematic review and meta-analysis used primary and alternate search terms (identified through MeSH searching) to retrieve relevant studies published up to April 2024 from global databases, including PubMed (Medline), Scopus, Embase, Web of Science, Cochrane Library, and ClinicalTrials.gov. The random-effects model was applied to calculate the weighted mean differences (WMD) and 95 confidence interval (95 CI) of the CBL for the meta-analysis. The quality of the included studies was assessed with the Cochrane Risk of Bias Tool (RoB 2). RESULTS: The meta-analysis revealed that the platform-switching technique significantly reduced CBL compared with conventional implant designs. On average, implants with platform switching showed a 0.22-mm reduction in CBL (WMD=-0.22; 95 CI=-0.39, -0.05; I(2)=58.18; P(heterogeneity)=.069). Subgroup analyses indicated that this reduction was most pronounced for single implants (WMD=-0.42; 95 CI=-0.49, -0.35) and at the posterior mandible site (WMD=-0.48; 95 CI=-1.11, -0.15). Conventional loading restorations also showed a greater decrease in CBL compared with immediate and functional loading (WMD=-0.33 versus -0.06 and -0.08). Additionally, longer follow-up periods beyond 36 months resulted in a more substantial reduction in CBL (WMD=-0.50; 95 CI=-0.55, -0.45). CONCLUSIONS: These findings support the use of platform switching as a strategy to enhance implant stability and long-term outcomes, highlighting its potential for improving clinical practices in implant dentistry. Further research is recommended to confirm these benefits and explore the underlying mechanisms.