Dr. Alan MeltzerFROM THE DESK OF ALAN M. MELTZER DMD MScD
The behavior of bone around and between adjacent implants:
When an implant is exposed to the oral environment, there is classically bone loss to the first thread associated with the formation of biologic width. This genetically ordained formation of biologic width has two components which are described as horizontal and vertical. Each component measures about 1.5 millimeters.
If adjacent implants are greater than 3 millimeters apart, the horizontal components of biologic width fail to overlap and a bridge of bone will remain between them. This bridge of bone will support the soft tissue.
If adjacent implants are less than 3 millimeters apart, then, as biologic width forms, the horizontal components of biologic width overlap and destroy the interproximal bridge of bone, eliminating the required soft tissue support producing a significant black triangle.
Preserve the inter-implant bone and support the soft tissue.
Remember only 3.5 millimeters of soft tissue covers the inter-implant bony crest
A method of reducing the impact of the formation of biologic width through the use of platform switching will be explored in my next monograph.
Photos courtesy of Dr. R. Coucchetto-Italy