Platform bone switch to increase cervical ring bone mass

A tapered straight-wall implant and a reverse conical neck implant were compared at the cervical margin in terms of bone volume of the ring of bone showing long term clinical application. One reverse conical neck implant, the reverse concave neck implant, showed a substantial difference in ring of bone volume with an increase of 5.57 mm when compared to a straight-wall implant. Favorable strategies at the cervical crestal two millimeters include narrowing of the neck, the so called conical neck, reverse concave neck and multiple cervical grooves all of which add incrementally to preserve dense crestal bone. The importance of cervical ring of bone mass is often unnoticed but becomes highly important in compromised, tight interdental spaces such as a 6 mm diameter space or in a setting where buccal bone is thin or lost leading to implant surface exposure because of loss of integrity of the ring of bone. One cannot always make corrections for dehiscence in the ring of bone by bone grafting such as is done facially, particularly when the dehiscence may go unnoticed or develop soon after implant placement interrupting the continuity of protective crestal bone. Though a tooth root may do adequately with as little as 1 mm of bone coverage an implant needs more, such as 2 mm or more, to buttress against bacterial insult and other potential resorptive stresses. An overall increase in bone volume due to a platform bone switch leads to greater cervical bone mass as a starting point for osseointegration maintenance. These findings also suggest that this greater bone mass for maintaining adequate bone at the margin of the implant which if otherwise lost could lead to periimplantitis.