International Journal of Prosthodontics and Restorative Dentistry

Register      Login

VOLUME 14 , ISSUE 1 ( January-March, 2024 ) > List of Articles


Association of Platform Shifting with Bone Remodeling and Cytokine Levels in Peri-implant Sulcus Fluid in Single Tooth Implants: A Split-mouth Study

Shefali Singla, Lalit Kumar, Mili Gupta, Manjot Kaur

Keywords : Abutment, Crestal bone loss, Implant abutment junction, Interleukin-1β, Platform match, Platform switch

Citation Information : Singla S, Kumar L, Gupta M, Kaur M. Association of Platform Shifting with Bone Remodeling and Cytokine Levels in Peri-implant Sulcus Fluid in Single Tooth Implants: A Split-mouth Study. Int J Prosthodont Restor Dent 2024; 14 (1):10-15.

DOI: 10.5005/jp-journals-10019-1438

License: CC BY-NC 4.0

Published Online: 30-03-2024

Copyright Statement:  Copyright © 2024; The Author(s).


Purpose: The purpose of this prospective split-mouth study was to compare crestal bone loss (CBL) and interleukin-1β (IL-1β) and C-terminal telopeptide (CTX) levels in peri-implant sulcus fluid (PISF) between implants restored with platform matched (PM) and platform switched (PS) abutments. Materials and methods: A total of 50 single tooth implants of 4.6 mm diameter were placed crestally in 25 patients (two implants in each patient) in the molar region. After 3 months, each of the two implant sites in each patient was randomly restored with a PM and a PS abutment (3.8 mm), and prostheses were given. The bone loss was calculated using a digital radiograph after abutment placement (baseline), 6 months, 1 year, and 2 years of loading. During each interval, PISF was collected around the implant and IL-1β and CTX were estimated using an enzyme-linked immune sorbent assay. The mean difference in bone loss and IL-1β levels within and between the two groups were compared using one-way analysis of variance (ANOVA) and independent t-tests. About 80% of PISF samples at baseline and 90% of samples of subsequent visits developed very negligible or no color and thus were considered negative for CTX. Results: The bone loss found at baseline was 0.82 ± 0.54 mm in the PM group and 0.69 ± 0.47 mm in the PS group (p = 0.376). At 6 months, the total bone loss was 1.05 ± 0.62 mm in the PM group and 0.97 ± 0.58 mm in the PS group, and increased to 1.11 ± 0.60 and 1.03 ± 0.64 mm, respectively in 2 years of follow-up. IL-1β levels were 4.52 ± 5.24 and 5.30 ± 6.38 ng/mL in the PM and PS groups, respectively (p = 0.175) at baseline. The levels decreased to 0.73 ± 0.83 ng/mL and 0.59 ± 0.54 ng/mL in the two groups, respectively, at 2-year follow-up. An insignificant difference was found in bone loss and IL-1β levels of both groups during the follow-up. Conclusion: Within the limitation of the study, the extent of bone loss and PISF IL-1β levels were insignificantly different when PM and PS abutments were used with the same implant system. IL-1β levels reflected the extent of inflammation associated with the implant site, which decreased with time.

PDF Share
  1. Gardner DM. Platform switching as a means to achieving implant esthetics. N Y State Dent J 2005;71(3):34–37. PMID: 16013682.
  2. Lazzara RJ, Porter SS. Platform switching: a new concept in implant dentistry for controlling postrestorative crestal bone levels. Int J Periodont Restorat Dent 2006;26(1):9–17. PMID: 16515092.
  3. Rocha S, Wagner W, Wiltfang J, et al. Effect of platform switching on crestal bone levels around implants in the posterior mandible: 3 years results from a multicentre randomized clinical trial. J Clin Periodontol 2016;43(4):374–382. DOI: 10.1111/jcpe.12522
  4. Telleman G, Raghoebar GM, Vissink A, et al. Impact of platform switching on peri-implant bone remodeling around short implants in the posterior region, 1-year results from a split-mouth clinical trial. Clin Impl Dent Relat Res 2014;16(1):70–80. DOI: 10.1111/j.1708-8208.2012.00461.x
  5. Pozzi A, Tallarico M, Moy PK. Three-year post-loading results of a randomised, controlled, split-mouth trial comparing implants with different prosthetic interfaces and design in partially posterior edentulous mandibles. Eur J Oral Implantol 2014;7(1):47–61. PMID: 24892113.
  6. Cappiello M, Luongo R, Di Iorio D, et al. Evaluation of peri-implant bone loss around platform-switched implants. Int J Periodont Restorat Dent 2008;28(4):347–355. PMID: 18717373.
  7. Fickl S, Zuhr O, Stein JM, et al. Peri-implant bone level around implants with platform-switched abutments. Int J Oral Maxillofac Implant 2010;25(3):577–581. PMID: 20556258.
  8. Canullo L, Rosa JC, Pinto VS, et al. Inward-inclined implant platform for the amplified platform-switching concept: 18-month follow-up report of a prospective randomized matched-pair controlled trial. Int J Oral Maxillofac Implant 2012;27(4):927–934. PMID: 22848896.
  9. Prosper L, Redaelli S, Pasi M, et al. A randomized prospective multicenter trial evaluating the platform-switching technique for the prevention of postrestorative crestal bone loss. Int J Oral Maxillofac Implant 2009;24(2):299–308. PMID: 19492646.
  10. Zarandi A, Novin M. Marginal bone loss around platform-switched and non-platform switched implants after two years of placement: a clinical trial. J Dent Res Dent Clin Dent Prospect 2017;11(1):26–29. DOI: 10.15171/joddd.2017.005
  11. Raco A, Murro BD, Passarelli PC, et al. Long-term clinical and radiographic analysis of platform matching and platform switching implants in the esthetic zone: a retrospective cohort study. Appl Sci 2023;13(1):661. DOI: 10.3390/app13010661
  12. Lago L, da Silva L, Martinez-Silva I, et al. Radiographic assessment of crestal bone loss in tissue-level implants restored by platform matching compared with bone-level implants restored by platform switching: a randomized, controlled, split-mouth trial with 3-year follow-up. Int J Oral Maxillofac Implant 2019;34(1):179–186. DOI: 10.11607/jomi.6954
  13. Enkling N, Jöhren P, Katsoulis J, et al. Influence of platform switching on bone-level alterations: a three-year randomized clinical trial. J Dent Res 2013;92(12 Suppl):139–145. DOI: 10.1177/0022034513504953
  14. Rokn AR, Badri S, Rasouli Ghahroudi AA, et al. Comparison of bone loss around bone platform shift and non-bone platform shift implants after 12 months. J Dent Tehran Iran 2015;12(3):183–187. PMID: 26622270.
  15. Atieh MA, Ibrahim HM, Atieh AH. Platform switching for marginal bone preservation around dental implants: a systematic review and meta-analysis. J Periodontol 2010;81(10):1350–1366. DOI: 10.1902/jop.2010.100232
  16. Monje A, Pommer B. The concept of platform switching to preserve peri-implant bone level: assessment of methodologic quality of systematic reviews. Int J Oral Maxillofac Implant. 2015;30(5):1084–1092. DOI: 10.11607/jomi.4103
  17. DI Girolamo M, Calcaterra R, DI Gianfilippo R, et al. Bone level changes around platform switching and platform matching implants: a systematic review with meta-analysis. Oral Implantol 2016;9(1):1–10. DOI: 10.11138/orl/2016.9.1.001
  18. Güncü GN, Akman AC, Günday S, et al. Effect of inflammation on cytokine levels and bone remodelling markers in peri-implant sulcus fluid: a preliminary report. Cytokine 2012;59(2):313–316. DOI: 10.1016/j.cyto.2012.04.024
  19. Wang HL, Garaicoa-Pazmino C, Collins A, et al. Protein biomarkers and microbial profiles in peri-implantitis. Clin Oral Implants Res 2016;27(9):1129–1136. DOI: 10.1111/clr.12708
  20. Meyer S, Giannopoulou C, Courvoisier D, et al. Experimental mucositis and experimental gingivitis in persons aged 70 or over. Clinical and biological responses. Clin Oral Implants Res 2017;28(8):1005–1012. DOI: 10.1111/clr.12912
  21. Shimpuku H, Nosaka Y, Kawamura T, et al. Genetic polymorphisms of the interleukin-1 gene and early marginal bone loss around endosseous dental implants. Clin Oral Implants Res 2003;14(4):423–429. DOI: 10.1034/j.1600-0501.2003.110823.x
  22. Lin YH, Huang P, Lu X, et al. The relationship between IL-1 gene polymorphism and marginal bone loss around dental implants. J Oral Maxillofac Surg 2007;65(11):2340–2344. DOI: 10.1016/j.joms.2007.06.673
  23. Rosen H, Moses A, Garber J, et al. Serum CTX. A new marker of bone resorption that shows treatment effect more often than other markers because of low coefficient of variability and large changes with bisphosphonate therapy. Calcif Tissue Int 2000;66(2):100–103. DOI: 10.1007/pl00005830
  24. Akman AC, Buyukozdemir Askin S, Guncu GN, et al. Evaluation of gingival crevicular fluid and peri-implant sulcus fluid levels of periostin: a preliminary report. J Periodontol 2018;89(2):195–202. DOI: 10.1902/jop.2017.170315
  25. Kocak-Oztug NA, Adem-Siyli GZ, Abishev O, et al. Analysis of biomarkers and marginal bone loss in platform-switched and nonplatform-switched implants: a randomized clinical trial. Biomed Res Int 2022;2022:2603287. DOI: 10.1155/2022/2603287
  26. World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. JAMA 2013;310(20):2191–2194 DOI: 10.1001/jama.2013.281053
  27. Meloni SM, Lumbau A, Baldoni E, et al. Platform switching versus regular platform single implants: 5-year post-loading results from a randomised controlled trial. Int J Oral Implantol 2020;13(1):43–52. PMID: 32186286.
  28. Esposito M, Maghaireh H, Pistilli R, et al. Dental implants with internal versus external connections: 5-year post-loading results from a pragmatic multicenter randomised controlled trial. Eur J Oral Implantol 2016;9 Suppl 1(2):129–141. PMID: 27314118
  29. Uraz A, Isler SC, Cula S, et al. Platform-switched implants vs platform-matched implants placed in different implant-abutment interface positions: a prospective randomized clinical and microbiological study. Clin Implant Dent Relat Res 2020;22(1):59–68. DOI: 10.1111/cid.12873
  30. Lin HK, Lin JC, Pan YH, et al. Peri-implant marginal bone changes around dental implants with platform-switched and platform-matched abutments: a retrospective 5-year radiographic evaluation. J Pers Med 2022;12(8):1226. DOI: 10.3390/jpm12081226
  31. Hsu YT, Lin GH, Wang HL. Effects of platform-switching on peri-implant soft and hard tissue outcomes: a systematic review and meta-analysis. Int J Oral Maxillofac Implants 2017;32(1):e9–e24. DOI: 10.11607/jomi.5140
  32. Palaska I, Tsaousoglou P, Vouros I, et al. Influence of placement depth and abutment connection pattern on bone remodeling around 1-stage implants: a prospective randomized controlled clinical trial. Clin Oral Implants Res 2016;27(2):e47–56. DOI: 10.1111/clr.12527
  33. Canullo L, Quaranta A, Teles RP. The microbiota associated with implants restored with platform switching: a preliminary report. J Periodontol 2010;81(3):403–411. DOI: 10.1902/jop.2009.090498
  34. Menger MD, Vollmer B. Surgical trauma: hyperinflammation versus immunosuppression? Langenbecks Arch Surg 2004;389(6):475–484. DOI: 10.1007/s00423-004-0472-0
  35. Dellavia C, Canullo L, Allievi C, et al. Soft tissue surrounding switched platform implants: an immunohistochemical evaluation. Clin Oral Implant Res 2013;24(1):63–70. DOI: 10.1111/j.1600-0501.2011.02301.x
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.