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Introdução: A manutenção óssea peri-implantar representa hoje em dia um tema de debate
interessante enquanto esta intimamente ligado ao prognostico das reabilitações protéticas
implanto-suportadas. A estrutura implantar bem como o tipo de conexão implante-pilar, são
fatores que podem contribuir a perda óssea peri-implantar e afetar negativamente o
prognostico do tratamento. Os dois desenhos de implante-pilar mais utilizados atualmente
são a ligação hexagonal externa e a ligação morse.
Objetivo: avaliar o nível de evidência científica sobre a manutenção da crista óssea
alveolar e os parâmetros clínicos associados, após a colocação de implantes cone-morse
e hexagonal externo, de modo a alcançar a previsibilidade clínica sobre o tema abordado.
Materiais e métodos: A literatura considerada para esta revisão sistemática é baseada
nas diretrizes PRISMA e visou responder a seguinte questão específica construída no
formato PICO: “Para pacientes tratados com implantes dentários (P), seja conexão externo
(I) ou cone-morse (C), existem diferenças na manutenção da crista óssea após pelo menos
seis meses em função (O)? Foi realizada uma pesquisa eletrónica nas bases de dados
MEDLINE®/Pubmed, Embase e Wiley a fim de identificar estudos clínicos comparando a
perda óssea em torno de implantes hexágono esterno e cone-morse com um período de
acompanhamento mínimo de seis meses. Os dados obtidos a partir dos estudos incluídos
foram extraídos e analisados através de uma meta-análise de modelo de efeitos aleatórios
contínuos. A variável primária utilizada foi a perda óssea marginal.
Resultados: A pesquisa inicial identificou 110 artigos. No entanto, 6 artigos foram
considerados adequados após a leitura do texto completo e foram incluídos no estudo. A
literatura analisada revelou uma diferença na perda óssea peri-implantar nos dois tipos de
conexões analisados (p< .001). Os parâmetros clínicos secundários e a sobrevivência
implantar associada aos dois tipos de ligação não revelaram diferencias significativas.
Conclusão: Os resultados da presente revisão sistemática sugerem que a manutenção
óssea marginal é maior em implantes com uma conexão morse. Contudo, devido ao número
limitado de estudos clínicos incluídos nesta revisão, os dados devem ser analisados com
cuidado. Portanto, necessárias mais investigações, incluindo um maior número de
pacientes, um tempo de seguimento mais longo e um controlo adequado dos fatores de
confusão.
Introduction: Peri-implant bone maintenance represents an interesting topic of debate as it is closely linked to the prognosis of implant-supported prosthetic rehabilitations. The implant structure as well as the type of implant-abutment connection are factors that can contribute to peri-implant bone loss and negatively affect treatment prognosis. The two most used implant-abutment designs today are the external hexagon connection and the morsetaper connection. Objective: Evaluate the level of scientific evidence on alveolar crestal bone maintenance and associated clinical parameters after placement of morse taper and external hexagon implants, to achieve clinical predictability on the topic addressed. Materials and methods: The literature considered for this systematic review is based on PRISMA guidelines and aims to answer the following specific question constructed in PICO (Population, Intervention, Control, Outcomes) format: "For patients treated with dental implants (P), either external connection (I) or morse taper (C), are there differences in bone crest maintenance after at least six months in function (O)? An electronic search in MEDLINE®/Pubmed, Embase and Wiley databases was performed to identify clinical studies comparing bone loss around external hexagon and morse taper implants with a minimum follow-up period of six months. The data obtained from the included studies were extracted and analyzed using a continuous random effects model meta-analysis. The variable used was marginal bone loss. Results: The initial search identified 110 articles. However, 6 articles were considered adequate after reading the full text and were included in the study. The literature reviewed revealed a difference in peri-implant bone loss in the two types of connections analyzed (p< .001). The secondary clinical parameters and implant survival associated with the two connection types revealed no significant differences. Conclusion: The results of the present systematic review suggest that bone maintenance is higher for implants with a cone-morse connection. However, due to the limited number of clinical studies included in this review, it is suggested to take care with the interpretation of the results. Further investigations are therefore needed, including a larger number of patients, a longer follow-up time and adequate control for confounding factors.
Introduction: Peri-implant bone maintenance represents an interesting topic of debate as it is closely linked to the prognosis of implant-supported prosthetic rehabilitations. The implant structure as well as the type of implant-abutment connection are factors that can contribute to peri-implant bone loss and negatively affect treatment prognosis. The two most used implant-abutment designs today are the external hexagon connection and the morsetaper connection. Objective: Evaluate the level of scientific evidence on alveolar crestal bone maintenance and associated clinical parameters after placement of morse taper and external hexagon implants, to achieve clinical predictability on the topic addressed. Materials and methods: The literature considered for this systematic review is based on PRISMA guidelines and aims to answer the following specific question constructed in PICO (Population, Intervention, Control, Outcomes) format: "For patients treated with dental implants (P), either external connection (I) or morse taper (C), are there differences in bone crest maintenance after at least six months in function (O)? An electronic search in MEDLINE®/Pubmed, Embase and Wiley databases was performed to identify clinical studies comparing bone loss around external hexagon and morse taper implants with a minimum follow-up period of six months. The data obtained from the included studies were extracted and analyzed using a continuous random effects model meta-analysis. The variable used was marginal bone loss. Results: The initial search identified 110 articles. However, 6 articles were considered adequate after reading the full text and were included in the study. The literature reviewed revealed a difference in peri-implant bone loss in the two types of connections analyzed (p< .001). The secondary clinical parameters and implant survival associated with the two connection types revealed no significant differences. Conclusion: The results of the present systematic review suggest that bone maintenance is higher for implants with a cone-morse connection. However, due to the limited number of clinical studies included in this review, it is suggested to take care with the interpretation of the results. Further investigations are therefore needed, including a larger number of patients, a longer follow-up time and adequate control for confounding factors.
Descrição
Palavras-chave
Implante dentário Perda óssea marginal Morse Hexágono externo Dental implants Marginal bone loss External hexagon