SWITCHING

KONSTANTIN GROMOV, DDS

Wednesday, May 29, 13

PLATFORM

The termPlatform Switching

2006

1991 - wider implants for soft bone and lack of stability), standard 4mm components - less bone loss

Wednesday, May 29, 13

2001

Apical migration of JE to protect the internal part of the body from inammation
Wednesday, May 29, 13

PS?

Soft tissue <3mm - remodeling

Wednesday, May 29, 13

1997

Wednesday, May 29, 13

Soft tissue thickness effect on bone loss and relation to PS

THIN<4.22mm<THICK + PS = enough room for BW

7x9mm

LESS BONE LOSS !

Wednesday, May 29, 13

No initial x-rays(?)
Wednesday, May 29, 13

2008

Biomet 3i Prevail 4/5/4 was removed after 2 months from a patient

0.35 mm

Wednesday, May 29, 13

Wednesday, May 29, 13

2009

Immediate placement, external hex vs PS - no difference Supra-crestal placement - external hex?

Wednesday, May 29, 13

2009

5 year follow-up, almost no bone loss 20-30 Ncm for IL (vs 30-40 Ncm) Morse connection - cold welding Esthetics, emergence prole? Quite a lot narrow 3,5mm implants

Wednesday, May 29, 13

2007

2 mm sub-crestally, loaded, retrieved 1 month Almost none inammatory cells, no brotic tissue

Wednesday, May 29, 13

Extreme PS, one connection Very easy surgical part, 20-30Ncm - IL Bone stability Questionable esthetics for single units, FPDs Unusual Prosth
Wednesday, May 29, 13

2.53 mm

vs 0.76 mm

Benets of an Implant Platform Modication Technique to Reduce Crestal Bone Resorption Xavier Vela-Nebot, MD, DDS,* Xavier Rodr guez-Ciurana, MD, Carlos Rodado-Alonso, MD,

Wednesday, May 29, 13

180

90

Plaque induced inammation vs Micro-gap induced inammation Mesializing micro-gap, causing inammatory cell inltrate (ICT) Shifts the mechanical stress away from coronal bone-impl interface Reestablishment of BW horizontal component

Moreover, with the increased surface area created by the exposed implant seating surface, there might be a reduction in the amount of crestal bone resorption necessary to expose a mini- mum amount of implant surface to which the soft tissue can attach (Lazzara & Porter 2006).
Wednesday, May 29, 13

2012

Disconnecting - reconnecting healing abutments (5 times) PS - circular pattern of CT bers at platform NPS - at the rst thread

Wednesday, May 29, 13

9 MONTHS
2010

ridge>7mm, two-stage micro threads, internal connection early cover screw exposure - exclusion from the study
Wednesday, May 29, 13

2009

Wednesday, May 29, 13

2 mm
2013

4 mm

Wednesday, May 29, 13

SWITCHING

No difference single-stage vs two-stage Esthetic considerations, location of the implant (TL?) Need 3-4 mm of soft tissue for PS to work One abutment-one time protocol No universal implant system Always think about the restorative outcome INFLAMMATION - BONE LOSS!
Wednesday, May 29, 13

PLATFORM

History Biology Benets Disadvantages Measurements Design variety (prevale, ankylos, astra, built-in by def. how many mm? need more than .35?

or just versality of abt) - 1-piece-2-pice (welding impl article?) Summary extras: 1 abt-1 time, emergence vs PS PS vs external hex (tissue level) No bone loss - wheres bone level initially? loosing 1.5-2mm after abt (healing) connection vertical positioning of the platform - ? at, below, above 0.4mm??,(piattelli) sloped platform switching, one abt-one time (desturbance articles?) graphics - positioning of the impl - what might happen bers orientation NPS vs PS connecting-reconnecting components - is epithelial faster than connective tissue? bone growth over the PS ? tapered, morse - less mobility 15-20Ncm - enough IL(?) - cold welding

show graphic - related articles and studies concl - no diff 1vs2stage, PS when possible, TL when possible (even better), 3-4mm soft
tissue, one abutm one time, ANKYLOS when thin tissue(?) and no esthetics

Wednesday, May 29, 13