IM0110

20 I I research _ platform switching Fig.1_Factors affecting bone changes around titanium dental implants implants1_2010 _Over the last decades, osseointegrated dental implants have proven to be highly predictable and largelyacceptedastreatmentmodalityforthereha- bilitation of partially and completely edentulous jaws. Being considered the most aesthetical and func- tional alternative to missing teeth, dental implants are used as prosthetic supports and expected to withstandcomplexocclusalload.However,theyalso have to confront the effects of additional factors such as oral microflora or elevated parafunctional forces. _Introduction Several factors such as implant design and sur- face, implant abutment interface or connection, bone architecture, prosthodontic restoration type and loading conditions may have effect on bone modelling and remodelling around the implants. The generally accepted criterion for implant suc- cessisthatlessthan0.2mmofalveolarbonelossper year should occur after the first year in function.1 What is overlooked, however, is that the implant therapy success is determined after the first year of service because most of the bone loss occurs during thefirst12monthsfollowingabutmentconnection.2 Therefore, the 2 mm loss of crestal bone over the first year might be considered a normal characteris- ticofahealthilyfunctioningimplantandthischange in bone height is merely due to remodelling in re- sponse to loading. The questions that need to be redressed are whether this small amount of bone loss exerts any clinical significance and whether it can be consid- ered acceptable. Dental implants have two goals to fulfil: an aes- thetic one and functional one. The loss of crestal bone and soft tissue may have important implica- tions for aesthetic implant restorations, which are reliant on healthy and constant soft tissue dimen- sions over time. The aesthetic replacement of teeth hasbecomeanimportantstandardforimplantden- tistry, leading to further research regarding the fac- tors contributing to crestal bone loss around two stage implants (Fig. 1). Bone adaptation under loading conditions Bone is a tissue that changes its mass and inter- nal architecture adapting itself to the loading con- The concept of “platform switching” in implant dentistry A literature review—Part I Author_Virgil Koszegi Stoianov, Romania Physiological factors u Occlusal loading Pathological factors u Parafunctional forces u Oral microbial flora Factors related to implant / bone u Implant design u Implant surface u Bone-implant interface u Bone quality CRESTAL BONE STABILITY BONE MODELLING BONE REMODELLING Fig. 1