The mechanical complications of platform switching connection on implant supported restorations: A systematic review and meta-analysis

Aim Platform implant abutment connection proved success in preserving crestal bone around implants, but the increased stress concentration on the prosthetic components is still a question.The primary aim of this systematic review was to evaluate the available evidence on the mechanical effect of implant platform switching concept on implant prosthetic components.

Methods A protocol of electronic and hand research was performed for English based researches comparing one or more PS groups with one or more PM groups to develop an answer for the following question: "Will the platform switching technique affect the amount of stresses generated within implant prosthetic components causing mechanical complications? A meta-analysis was performed to evaluate the impact of implant-abutment platform mismatch on implant prosthetic components.

Results Eleven publications from twenty research studies were included. Results from the meta-analysis demonstrated the odds of survival in the Platform matching connection arm are 2.13 times more compared to the Platform switching arm.  (P-value= 0.0316) For the random effects model, the odds of survival in the PS arm is not statistically significantly different compared to the PM arm (p-value= 0.2224) due to substantial heterogeneity of the included studies results in regards to implant prosthetic components mechanical complications.

Conclusion This systematic review showed higher stress concentration in the implant prosthetic components regarding using platform switched implants, more randomized controlled clinical trials with bigger samples are needed to confirm our findings, but the current evidence demonstrates that non-significant differences between platform switching concept and platform matching. It is recommended to further investigate the mechanical complications that might arise when platform switching concept is used.