Platform Switching and the Kai Foo's Three Critical Margins of Dental Implants


  • K. F. Chow BDS., FDSRCS May 20th, 2010
    The term “platform switching” may be a misnomer. Misnomer means using the wrong word to describe something. The platform that we are referring to is the round surface area on top of the fixture in which the screw hole for the abutment is located. Branemark set the trend by making sure that the abutment fits exactly over the top-surface of fixture, with the periphery flush with each other……which is a logical decision at the time….and everyone copied him…….which always resulted in a “normal” resorption of the bone away from the junction.
    The advantage of “platform switching” was discovered when a dentist did not have the right sized abutment to fit flush with the fixture and inserted an abutment whose circumference/undersurface area was smaller than the platform/topsurface area of the fixture. This happily and unintentionally took the junction/microgap/microorganisms away from the bone and thus to the pleasant astonishment of the dentist after reviewing the xray, showed that the so-called acceptable normal resorption of the bone away from the implant ceased!!
    Thus “platform switching/shifting” was born. The platform however remained the same and was never switched or shifted. That is why i think that it is a misnomer, i.e. wrong word. What changed was the circumferential size of the abutment. An abutment with a smaller circumference than that of the fixture was then resting on the top-surface of the fixture.
    Maybe the right term should be “abutment downsizing” or “footprint reduction” or just simply “platform mismatch” or “margin shifting” or “green technology” or …”gum friendly”…or “shy margins”…….. oh hack…just call it “platform switching” to comply with the aura of mystery and awe that implant dentistry should continue to have for old times sake!!!!!!
    If you understand the concept, then you can easily see which implant system is platform switching and which is not.
    There are 3 critical margins in implant dentistry. I call them "Kai Foo's Three Critical Margins". The abutment-fixture margin, the crown-abutment margin and the emergence margin…altogether is found within the transmucosal passage of the implant.
    Platform switching has solved the problem of the abutment-fixture margin. Most savvy manufacturers are all moving towards this design. The crown-abutment margin is still unresolved whether you screw or cement, it still poses an inflammatory problem.
    As for the emergence margin…..one solution may be to reduce the circumference by reducing the diameter of the emerging dental implant. But with our emphasis on the “emergence profile” for the sake of aesthetics, it is unlikely to be practiced widely. As the Chinese have a saying..”Oi lang…Ng moi mang”…which translates as wanting beauty even at the expense of life and health.
    ‘Nuff said.

Komentar

Posting Komentar

Postingan populer dari blog ini

NARROW DIAMETER DENTAL IMPLANTS: POSTED IN OSSEONEWS

K. F. Chow BDS., FDSRCS   says: October 23, 2009 at 11:26 am THE CASE FOR NARROW DIAMETERS/MINIS/REDUCED DIAMETERS/ MINIMIZED DENTAL IMPLANTS/MOSTDIS Narrow diameter dental implants are being increasingly used not only to stabilize dentures but also for long term applications like crowns and bridges. I agree with Carl in that there is no such thing as an absolute contraindication in medicine. Even botox which will kill you if injected into your bloodstream is used ingeniously and judiciously to extend the youthful looks of people. The key word is “judiciously”. Know your medicine well and know what you want to do with it and then you can apply it safely and usefully. It is significant that one of the doyens of implant dentistry has recognized that narrow diameters have their uses especially in narrow ridges and in suitable bone. I started out with conventionals and with the advent of minis, incorporated them into my treatment planning and in many complex cases have successfully integra
Baca selengkapnya

Numbness After Implants | OsseoNews Discussions on Dental Implants

Numbness After Implants | OsseoNews Discussions on Dental Implants : "Dr Amayev September 11th, 2006 No matter what kind of surgeons you are anything could happen .Of course we must try to ovoid any possible complication to our patient and treat them with respect but sometimes complication may happen. In order to avoid any possible complication we should just stop what we are doing as been previously mention by Dr Kfchow. I don’t believe that there is a dentist or another type of medical professional or any other profession who never had a complication. We all humans and if we did something we have to try to resolve and help that patient in any possible way if we can. From what Lerry or Ben told us, I don’t know you are a doctors or not but if you are it seems like you both the best and never had any complications in your practice. If you didn’t I am very happy for both of you. Never say this may not happen to you ,look in a future you still practicing. Think about that. May be yo
Baca selengkapnya

NARROW DIAMETER DENTAL IMPLANTS

K. F. Chow BDS., FDSRCS   November 13th, 2009 Thanks for the kind words guys. While I am yet feeling elated and therefore a little brash, let me push the debate a little further. We all know that the transmucosal passage of the dental implant when compared to the transmucosal passage of an actual, real, original living tooth is actually a pathetic imitation of the real thing. The real thing has a nice epithelial attachment with a nice drain around the tooth constantly flushed with antibacterial substances and prohealth nutrients for the gingivae. Not only that the gingival cuff has circular fibres, connective tissue to tooth fibres, bone to tooth fibres , connective tissue to bone fibres etc. that gives each tooth a nice firm resilient yet elastic cuff around the it. Go review your periodontology texts and see for yourself. The dental implant has only a pseudo epithelial attachment and a few if any specialised soft tissue fibres and at best is actually an iatrogenic and pat
Baca selengkapnya