Platform shift?? Straumann RC

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Markyboy

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I have a RC Straumann in a spot where a WN should be.
Prosthodontist was telling my Dr that it was done to save the bone (Platform Shift).
As I understand with Platform Shift it is just engaging the implant with an abutment at a higher level than the platform of the implant in order to save bone loss???
Not sure if that statement is correct. Never done one like this before.
Am I ordering a regular RC Variobase and building a massive crown on that small abutment or is there something else I should be ordering?
Of course my Straumann rep has gone MIA.
Thanks
M


2020-12-18 12.55.29.jpg
 
JMN

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Grab a large grain of salt as I may be wrong (see signature)

But... I'd be highly nervous to shift larger instead of smaller. The abuyment will take more stress than the implant and snappo! broken implant appears.

That's my concern. And again, it may be unfounded.
 
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Markyboy

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So just get a regular RC and build a pumpkin on top? I can't imagine how much stress its going to put on that tiny implant. Am I missing something... how is this going to save bone loss? Is it because the RC engages above where a WN engages? Still not super clear on what platform shift is.
You ever get that feeling that whatever you do there is going to be a lot of wasted time and money down the road.
 
CatamountRob

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I don’t know the right answer, I just think that’s what you’ll wind up with. I cringe anytime I see a small bone level implant at or near tissue level in the posterior.
 
JMN

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So just get a regular RC and build a pumpkin on top? I can't imagine how much stress its going to put on that tiny implant. Am I missing something... how is this going to save bone loss? Is it because the RC engages above where a WN engages? Still not super clear on what platform shift is.
You ever get that feeling that whatever you do there is going to be a lot of wasted time and money down the road.
Platform shift means the subbrand specific antirotational and other features that make the implant and abutment interface (anything that is not a perectly flat rodface) will work with all size combinations (ss sm sl mm ml ll)
You cannot put a 'normal' small abutment on a 'normal' large implant. This allows that to be ppossible.

Wasted time and money? Every week.
 
2thm8kr

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Straumann RC is home level implant.
Straumann WN is tissue level. Completely different platform and connection. There is no platform switching between these implant types.

I'll take a blind guess that the surgeon used the bone level RC rather than the wider WN because the ridge was narrow at the placement site.....
 
JMN

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success easily averted once again.
 
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FullPartial

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Correct all you can do is use the RC platform. Either stock/custom/UCLA. I’d recommend going custom and telling the doctor it’s going to be a “high water” design.
 
Sda36

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Straumann RC is home level implant.
Straumann WN is tissue level. Completely different platform and connection. There is no platform switching between these implant types.

I'll take a blind guess that the surgeon used the bone level RC rather than the wider WN because the ridge was narrow at the placement site.....
Thanks 2th for pointing that out, was just about to. Had a "Talk" with a periodontist placing implants for Dr.'s, one of mine. I had issues with encode, which he liked, his hygienist could take care of the Itero scans. I tried to enlighten him that Itero only works with Straumann presently for their milled models and then blaa blaa how 3i is so wonderful. ( I do now prefer Straumann for range of components currently also)
I Still have a non-disclosure agreement with 3i for development of their system from 1987. Still don't like their approach and have had many disappointing results, all with their acknowledged fault. This kind of placement doc is a real pia. They restore nothing but know Everything. Remarkable!
 
Contraluz

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As I understand with Platform Shift it is just engaging the implant with an abutment at a higher level than the platform of the implant in order to save bone loss???
Platform shift/switching is whenever an abutment is used that is smaller in diameter than the implant platform. Many of the modern implant system have it already integrated in their system, like Straumann, with bone level.

images.jpeg

So, since your implant is a Straumann bone level, platform switch is already a given. However, like already mentioned above, the implant platform to crown ratio is quite a bit off and on top of it, you can't create an adequate emergence profile. Besides what has been said already, I'd recommend to keep the occlusion as reduced as possible.
 
doug

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Why does itero only work with Straumann? We can do anything with it. I do have the lab partner version, so maybe that's the difference.
 
Sda36

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Why does itero only work with Straumann? We can do anything with it. I do have the lab partner version, so maybe that's the difference.
You're probably right on the lab partner, same as us. Itero models only available for Straumman analogs, detachable. They don't produce models with analogs for any other systems 3i, nobel etc. Don't entirely know the reason for this other than likely exclusive deals likely at the heart of it and we suffer the consequences. I'm not a huge fan of "the look" of Itero models but they are rock solid and don't deteriorate through the production of the case. Printed still a bit off on some of those points IMHO.
 
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Markyboy

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Platform shift/switching is whenever an abutment is used that is smaller in diameter than the implant platform. Many of the modern implant system have it already integrated in their system, like Straumann, with bone level.

View attachment 37415

So, since your implant is a Straumann bone level, platform switch is already a given. However, like already mentioned above, the implant platform to crown ratio is quite a bit off and on top of it, you can't create an adequate emergence profile. Besides what has been said already, I'd recommend to keep the occlusion as reduced as possible.
Thank you that makes sense to me now. The straumann bone level "platform shift" is already integrated in the design.
Ordered a titanium custom abutment and will cement a zirconia with access hole. This should be the strongest option for a screw retained crown.
Merry Christmas everyone. Thanks for the information it is much appreciated.
 
Pronto

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I'll take a blind guess that the surgeon used the bone level RC rather than the wider WN because the ridge was narrow at the placement site.....
More than likely he looked in his drawer, had an RC and said ship it.
 
keith goldstein

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Why does itero only work with Straumann? We can do anything with it. I do have the lab partner version, so maybe that's the difference.
iTero works with many other implant systems and has for years. Even a number of 3rd parties where you can use their scan bodies (straumann) and then choose to use other manufacturers parts.
 
lcmlabforum

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This is in the FWIW department.
If the implant placed is too wide and there is less than adequate bone surrounding the implant, there will be bone loss.
As such, for the longevity of the implant, it is better to place a narrower implant to preserve the bone, but prosthetically
reduce the occl table as much as practical to minimize lateral loading.
Not every case can be bone grafted or ridge expanded.
LCM
 
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