The Need For Better Crestal Bone Preservation Emerges
Traditional two-stage implants have enjoyed a long history of clinical success and have offered surgical and prosthetic versatility. However, throughout the years it was recognized that this implant construct could be associated with a modest amount of crestal bone loss that tended to stabilize long-term at the first implant thread. Loss of crestal bone may result in a displacement of soft tissue, which can compromise aesthetics. This makes the preservation of crestal bone more important than ever before. It is one of the keys to an aesthetic outcome because it allows for the maintenance of the healthy soft tissue, specifically the interdental papillae and the buccal gingival margin.
The Accidental Discovery
In 1991, BIOMET 3i introduced 5.0 and 6.0mm wide diameter implants that offered the same external hex interface as their smaller cousins. During this period, some clinicians restored the implants with standard 4.0mm prosthetic components that were smaller than the larger diameter implant platform (Platform Switching).
The radiographic outcomes of these cases gave birth to an accidental discovery. Through time, clinicians restoring wide diameter or expanded platform implants in this manner have routinely seen a more consistent preservation of crestal bone.5
The fact that the implant-to-abutment interface now had a more medial location on the implant platform seemed to be limiting the remodeling of crestal bone.
