Authors : Suryanarayanan T.; Jothivenkat S. A.

Volume/Issue : Volume 11 - 2026, Issue 7 - July

Google Scholar : https://tinyurl.com/4bzsahnn

Scribd : https://tinyurl.com/bswxkakf

DOI : https://doi.org/10.38124/ijisrt/26jul798

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Abstract : This review article provides an exhaustive, critical analysis of the platform switching concept in dental implantology, focusing on its efficacy in mitigating marginal bone loss (MBL), ensuring soft tissue esthetics, and safeguarding long-term implant survival across diverse clinical scenarios. Material and Methods: A comprehensive comparative synthesis was conducted using data extracted from nine key contemporary publications, including landmark clinical trials, randomized split-mouth studies, and comprehensive meta-analyses spanning 2005 to 2016. These data pools were utilized to critically weigh historical consensus against rigid localized trial dynamics. Results: Traditional literature and large systematic meta-analyses firmly establish that shifting the implant-abutment junction (IAJ) perimeter inward toward the central axis relocates the inflammatory cell infiltrate (ICT) away from the bone crest, resulting in a statistically significant reduction in global MBL (mean savings ranging from 0.29 mm to 0.37 mm). This bone preservation scales proportionally with the magnitude of the horizontal mismatch. However, modern localized split-mouth randomized controlled trials reveal that when macro-diameters are isolated identically, micro-gap dynamics, surgical site trauma, healing times, and soft tissue biotypes heavily confound direct outcomes, often resulting in statistically equivalent MBL between switched and matched protocols during the initial healing phases. Conclusion: Platform switching remains a highly valuable prosthetic and surgical configuration to optimize long-term crestal bone architecture and interproximal esthetics. However, its bone-protective capabilities are multi-factorial and non-absolute, requiring careful clinical implementation tailored to individual mucosal dimensions and prosthetic spacing requirements.

Keywords : Platform Switching, Crestal Bone Loss, Biologic Width, Marginal Bone Loss, Implant-Abutment Junction, Systematic Review, Dental Implantology.

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