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3 SCIENCE | CLINICAL RESEARCH builds up the buccal soft tissue with a connective tissue graft in immediate implantation. This stabilizes the bone and improves the esthetic outcome. Giving clinical examples, Happe was able to demonstrate that the better sealing of the alveoli through the transplant plays an important role. By observing all these factors, it was possible to preserve the marginal soft tissue level with these measures [5]. In contrast, the type of connection between the implant and the abutment, whether parallel or tapered, has no effect on crestal bone degeneration according to the above mentioned systematic review of the literature [2]. Professor Schwarz had already formulated this thesis two years ago at the 4. International CAMLOG Congress in Lucerne on the basis of pre-clinical studies. However, a stable connection as, for example, given by the CAMLOG implant lines is to be recommended [1]. Platform Switching preserves bone The bone level, and as a consequence, soft tissue stability, also play a role in the horizontal stage between implant shoulder and abutment (Platform Switching). However, no clear recommen- dations could yet be made in the consensus paper on this issue [1]. According to the university lecturer Dr. Frank Strietzel (Charité Berlin, Germany) the present studies were too inconsistent. A published systematic review of the literature with Strietzel as lead author showed that the dimensions of horizontal shift and the type of connection are not standardized due to the large number of investigated implant systems [6]. In addition, the majority of implants studied were in the posterior range, so that only limited conclusions could be drawn for anterior teeth. However, the Platform Switching concept appears to offer advantages in principle and can be used as an alternative to flush outer connections according to the consensus. This is also supported by new studies and clinical observations presented in Valencia. For example, a randomized study presented by Professor Fernando Guerra for individual crowns on CAMLOG ® SCREW-LINE Promote ® plus implants (Tube-in-Tube ™ ) with Platform Switching, showed a higher ratio of stable bone level or bone growth (67.1%) after one year versus a flush outer comparison group (49.2%) [7]. Measurements were taken from the time of prosthetic restoration. An analog study in terms of indications and timelines is presently being conducted with CONELOG ® SCREW-LINE implants (tapered connection). The preliminary results presented are comparable to those achieved with CAMLOG ® SCREW- LINE implants with Platform Switching, with a slight average increase in bone growth after the time point of prosthetic restoration. New data on Platform Switching According to the systematic review of the literature initially mentioned, there is still insufficient data to document a possible relationship between soft tissue thickness and osseous restructuring as a function of vertical implant position [2]. On the topic of soft tissue and Platform Switching, Professor Wilfried Wagner (University of Mainz, Germany) quoted a newly published clinical study. This study showed that the bone level remains largely stable (0.21 mm degeneration 1 year after restoration) in the case of thick soft tissue types (> 2.0 mm) in conjunction with Platform Switching, whereas degeneration is greater for soft tissue thicknesses less than 2.0 mm (1.17 mm) [8]. Dr. Claudio Cacaci , oral surgeon from Munich, has many years of experience with sub-crestally placed implants with tapered connections. In Valencia he Prof. Frank Schwarz Dr. Arndt Happe University lecturer Dr. Frank Strietzel Dr. Claudio Cacaci Prof. Wilfried Wagner