Inward-inclined implant platform for the amplified platform-switching concept: 18-month follow-up report of a prospective randomized matched-pair controlled trial.

A to previous studies, when an implant is exposed to the oral environment, a vertical repositioning of hard and soft tissues takes place.1–5 The usual amount of this peri-implant bone remodeling over time in physiologic conditions is 2 to 3 mm, depending on arch, jaw region, the patient’s smoking status, bone quality, and the implant surface and design.6 Several factors may affect this postrestorative biologic process: (1) local and systemic patient-related factors (eg, smoking habits, systemic disease, soft tissue thickness and biotype, individual bone pattern, oral microbiology); (2) implant and prosthetic factors (eg, implant microand macrogeometry, prosthetic material and configuration); (3) surgical factors (eg, flap design, drilling procedure, stage-two surgery technique), and (4) biologic and/or biomechanical factors (eg, biologic width reestablishment, occlusal loading). Focusing on this last group, bone resorption may be related to the reestablishment of biologic width that takes place following bacterial invasion of the implant/abutment interface.7 Although controversial, additional bone resorption seems to be related to occlusal loading, which transfers stresses along the coronal bone-implant interface.8,9 A different theory has been proposed that is not 1 Department of Orthodontics and Prosthodontics, University of Bonn, Germany; Private Practice, Rome, Italy. [AU: Please add the professional titles of all authors at their institutions, eg, professor, research assistant, lecturer, clinical instructor.] 2Private Practice, Caxias do Sul, Brazil. 3Private Practice, Sao Paulo, Brazil. 4 Department of Orthodontics and Prosthodontics, University of Bonn, Germany. [AU: Were any of the authors affiliated with Department of Operative Dentistry, Faculty