Comparison of Crestal Bone Loss and Peri-Implant Clinical Outcomes Between Platform-Switched and Platform-Matched Dental Implants: A Prospective Observational Clinical Study

Introduction Preservation of the crestal bone is essential for the long-term success of dental implants. Platform switching has been proposed to minimize marginal bone loss by shifting the implant-abutment interface away from the crestal bone and improving stress distribution. This study aimed to compare the crestal bone loss and peri-implant clinical outcomes between platform-switched and platform-matched dental implants over a 12-month follow-up period. Materials and methods This prospective longitudinal observational study included 90 patients undergoing implant-supported rehabilitation, with 45 patients receiving platform-switched and 45 receiving platform-matched implants. Clinical and radiographic evaluations were performed at baseline and 6 and 12 months after prosthetic loading. Crestal bone loss was measured using standardized digital intraoral periapical radiographs. The secondary outcomes included probing depth, modified bleeding index, and modified plaque index. Data were analyzed using appropriate statistical tests and analysis of covariance, with statistical significance set at p < 0.05. Results Baseline demographic and clinical characteristics were comparable between the groups (p > 0.05). At 12 months, the platform-switched group demonstrated significantly lower crestal bone loss than the platform-matched group (0.80 ± 0.30 mm vs. 1.18 ± 0.37 mm; p < 0.001). Bone loss at six months was also significantly lower in the platform-switched group (0.49 ± 0.18 mm vs. 0.72 ± 0.22 mm; p < 0.001). The platform-switched group showed significantly lower probing depth (2.57 ± 0.36 mm vs. 3.02 ± 0.62 mm; p < 0.001) and modified bleeding index (0.53 ± 0.33 vs. 0.90 ± 0.37; p < 0.001), whereas modified plaque index did not differ significantly between groups (p = 0.080). The implant platform design remained an independent predictor of crestal bone preservation after covariate adjustment. Conclusion Platform-switched implants demonstrated superior crestal bone preservation and improved peri-implant soft tissue health compared to platform-matched implants after 12 months of functional loading. These findings support the use of platform-switched implant designs to enhance peri-implant tissue stability and reduce marginal bone remodeling.