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Purpose: The purpose of this study was to evaluate the effectiveness of the platform-switching technique to prevent crestal bone loss following the restoration of dental implants. Materials and Methods: This randomized prospective multicenter trial analyzed 60 partially edentulous adults recruited at 12 professional dental centers. Subjects were randomly selected to receive either platform-enlarged or control cylindric implants in three different surgical procedures: conventional nonsubmerged, submerged, and submerged with a reduced abutment. The primary outcome measure was the change in crestal bone level assessed radiographically 12 and 24 months following placement. Nonparametric analysis of variance for repeated measures (the Friedman test) was used to assess the overall significance over time of the differences among implants in changes in crestal bone levels. Comparisons among and between groups of implants were performed by the nonparametric Friedman and Wilcoxon tests, respectively. In all the analyses an ex = .05 was considered significant. Results: A total of 360 implants were placed (60 for each group). Three control implants failed during the 2nd year following placement. All submerged and 92% of nonsubmerged platform-enlarged implants exhibited no bone loss. Control implants with an abutment as large as the implant platform exhibited more bone loss than their platform-enlarged counterparts (P < .001) or control implants with a reduced abutment (p < .001). Submerged implants with an enlarged platform showed better crestal bone preservation than submerged control implants with a reduced abutment (P = .06). Conclusions: The findings of the current trial indicated that the use of implants with an enlarged platform can result in better preservation of crestal bone as compared with conventional cylindric implants when a reduced abutment is mounted. INT J ORAL MAXILLOFAC IMPLANTS 2009;24:299-308 [ABSTRACT FROM AUTHOR]

A three-dimensional finite-element model of a human mandible is presented, and the stresses and deformations computed for loading states induced by two different gnathologic reconstructions using six and four implants are discussed. Occlusal canine guidance and posterior and anterior group functions on cantilevered and distally supported prostheses have been simulated. The stress distributions generated by the different loading conditions on either the osseointegrated prosthesis or the bone tissue surrounding the implants are described. The analysis of the stress distribution on the working side reveals that the posterior group function undergoes a reduction in stress intensity on the cortical bone surrounding the implants (especially for the distal implant) compared with the anterior group function and canine guidance in both gnathologic reconstructions. © 1998 Chapman & Hall [ABSTRACT FROM AUTHOR]