Available online 17 April 2025

Author links open overlay panel, , , , , AbstractStatement 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; I²=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.

Section snippetsMATERIAL AND METHODS

This systematic review and meta-analysis adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines25 and was registered in the International Prospective Register of Systematic Reviews (PROSPERO) database (CRD42024523098).

The inclusion criteria, designed to explore the impact of platform switching on CBL, are presented in Table 1. A comprehensive search strategy was developed using keywords relevant to the study's topic and goals combined with the

RESULTS

A total of 708 articles were initially identified through the database searches. After removing 104 duplicates, 604 articles remained for title screening. This stage excluded 480 articles, leaving 124 for abstract screening. From these, 104 studies were excluded, resulting in 20 articles for full-text review. Of these, 2 studies were excluded for being review articles, 6 for irrelevant outcomes, 2 for lack of full-text access, and 2 for not having a control group, as illustrated in (Fig. 1).

DISCUSSION

The maintenance of peri-implant tissues and preservation of bone level around dental implants is essential for achieving the long-term success of dental implants.35 Variations in peri-implant bone levels are important for evaluating implant therapy outcomes, as bone levels indicate the health of peri-implant tissues.36

Typically implemented during and after prosthetic loading, the platform switching technique has been noted for contributing to marginal or crestal bone stability,37 and the

CONCLUSIONSBased on the findings of this systematic review and meta-analysis study, the following conclusions were drawn:1.

The platform switching technique significantly reduced CBL by 0.22 units.

2.

The technique is especially beneficial in addressing challenging clinical scenarios and during extended follow-up periods (>36 months) and contributes to improved long-term implant success.

3.

These findings specified the importance of prolonged patient monitoring to fully understand the bone-preserving advantages of

CRediT authorship contribution statement

Majedeh Nami: Conceptualization, Formal analysis, Investigation, Methodology, Project administration, Software, Supervision, Writing - original draft, Writing - review and editing. Hazhir Maslahaty: Formal analysis, Investigation, Resources, Writing - original draft, Writing - review and editing. Benika Abbasi: Data curation, Funding acquisition, Methodology, Resources, Supervision, Validation, Visualization, Writing - review and editing. Morteza Sharifi: Data curation, Funding acquisition,

Acknowledgments

The authors thank Kurdistan University of Medical Sciences (Sanandaj, Iran) for the provided support which enabled the successful completion of this study.

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