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The International Journal of Oral & Maxillofacial Implants



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Int J Oral Maxillofac Implants 30 (2015), No. 5     1. Oct. 2015
Int J Oral Maxillofac Implants 30 (2015), No. 5  (01.10.2015)

Page 1084-1092, doi:10.11607/jomi.4103, PubMed:26394345

The Concept of Platform Switching to Preserve Peri-implant Bone Level: Assessment of Methodologic Quality of Systematic Reviews
Monje, Alberto / Pommer, Bernhard
Purpose: To assess the methodologic quality of systematic reviews on the effect of platform switching upon peri-implant marginal bone loss.
Materials and Methods: An electronic literature search of several databases was conducted by two reviewers. Articles were considered for quality assessment if they met the following inclusion criterion: systematic reviews that aimed at investigating the effect of platform switching/mismatch on marginal bone levels around dental implants. Two independent examiners evaluated the review publications using two quality-ranking scales (assessment of multiple systematic reviews [AMSTAR] and Glenny checklist). Descriptive statistics were used to summarize the results, and Cohen's kappa coefficients were calculated to appraise interrater agreement of each checklist.
Results: Overall, five systematic reviews (including three of them with meta-analysis) were evaluated. The mean AMSTAR score ± standard deviation was 8.4 ± 2.6 (range, 4 to 11), and the mean Glenny score was 10.8 ± 2.9 (range, 6 to 14), showing high statistical correlation (rs = 0.98, P = .005). Cohen interexaminer test yielded values of κ = 0.88 and κ = 0.86 for the AMSTAR and Glenny checklist, respectively. The AMSTAR items rated positive in 78%, whereas 18% met the criteria for "no" and 4% were "not applicable." Only one review article met all criteria. Items of the Glenny checklist rated positive in 73% and negative in 27%. All but one study with the lowest quality scores (finding no difference) demonstrated a clinical benefit of implant platform switching in preserving the peri-implant marginal bone loss.
Conclusion: According to the quality-ranking scales appraised, substantial methodologic variability was found in systematic assessment of benefits with the platform switching concept to preserve peri-implant bone level. High-quality systematic reviews, however, generally favored platform switching over platform matching.

Keywords: bone regeneration, dental implants, dental implant-abutment design, evidence-based dentistry, platform switching, systematic review