Platform switching on wide-diameter external hex implants a finite element analysis

Objectives: The objective of this work was to use finite element analysis to compare the effect of forces coming to bear on abutments 4.1 or 5.0 mm in diameter connected to a 5.0 mm implant (i.e. with or without platform swit - ching). Study design: A 3D CAD model of a 5 x 11.5 mm external hex implant was developed, complete with a connection screw and either of two abutments, one 4.1 and the other 5 mm in diameter, to assess the influence of two loading conditions, i.e. 200 N loaded either axially or off center on the top of the abutment. Results and conclusions: In the symmetrically loaded models, greater stresses were transmitted to the bone in the area below the neck of the implant in the case of the wider-diameter abutment. When the narrower abutment was considered, the stress lines remained confined to the metal and were transferred to the bone in a more distal position. When the stresses in the bone where compared under non-symmetrical loading of the larger- and smaller-diameter abutments, the stresses reached lower values in the latter case. These findings indicate that platform switching (i.e. coupling a 4.1 mm abutment with a 5 mm implant) achieves a better, more even distribution of the peri-implant stresses deriving from simulated occlusal loads on the bone margins.