Effect of Platform Shift on Crestal Bone Levels and Mucosal Profile Following Flap Surgery and Subcrestal Implant Placement in Presence/Absence of Gap Defects

Brent A. Wenzel, Inãki Gamborena, Jaebum Lee, Tiago Fiorini, Peter Schüpbach, Ulf Me Wikesjö, Cristiano Susin

Research output: Contribution to journalArticle

3 Scopus citations


Background: Physiologic remodeling resulting in crestal bone loss appears a common corollary to dental implant surgery. Several hypotheses and clinical strategies have been advanced to explain and avert crestal remodeling; however, causative mechanisms remain unclear and the efficacy of clinical protocols uncertain. Purpose: The objective of the present study was to provide a histologic account of crestal bone levels and mucosal profile at implant sites receiving platform shift/switch and standard abutments following conventional flap surgery and subcrestal implant placement in presence or absence of crestal gap defects using a dog model. Materials and Methods: Four dental implants were placed into the left/right edentulated posterior mandible in five adult male Hound Labrador mongrel dogs using flap surgery including subcrestal placement with/without a 1×5mm (width × depth) gap defect, and using platform shift/switch and standard abutments. Block biopsies were collected for histological/histometric analysis following an 8-week healing interval. Results: No significant differences in crestal resorption were observed among experimental groups; crestal resorption being significantly more advanced at buccal than at lingual sites (p<.001). Similarly, crestal bone-implant contact was not significantly different among groups; crestal bone-implant contact being consistently below the implant platform at buccal sites (p<.01). Moreover, the peri-implant mucosal profile was not statistically different among groups, the mucosal height being significantly greater at buccal than at lingual sites (p<.001). Also, no significant differences among groups were observed for the apical extension of the epithelial attachment, the epithelial attachment being arrested more than 2mm above the implant platform at both platform shift/switch and standard abutments. Conclusions: Using a clinical strategy including flap surgery and subcrestal implant placement, implant technology comparing platform shift/switch with standard abutments, surgical approach, and abutment selection seems to have a limited impact on crestal remodeling, associated bone loss, and mucosal profile.

Original languageEnglish (US)
Pages (from-to)217-225
Number of pages9
JournalClinical implant dentistry and related research
Issue number2
StatePublished - Apr 1 2016



  • Alveolar bone
  • Animal models
  • Crestal resorption/remodeling
  • Dental implants
  • Platform shift/switch

ASJC Scopus subject areas

  • Oral Surgery
  • Dentistry(all)

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