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Authors
Abstract(s)
Introdução:
Existem várias técnicas cirúrgicas para a preservação alveolar, entre as quais se destaca
uma técnica desenvolvida por Tarnow, mais conhecida como “Ice Cream Cone”, utilizada
em alvéolos tipo II, em que a cortical vestibular se apresenta parcialmente danificada depois
da extração dentária.
O objetivo deste estudo é determinar as alterações dimensionais ocorridas em alvéolos tipo
II, reabilitados com implantes imediatos e com a técnica “Ice Cream Cone” para
reconstrução da cortical vestibular nesta modalidade de tratamento.
Materiais e Métodos
O presente estudo foi de natureza observacional retrospetiva de implantes imediatos pósextração previamente colocados em alvéolos do setor anterior maxilar que apresentavam
algum tipo de defeito ósseo associado à cortical óssea vestibular. Os pacientes foram
submetidos a um scanner ótico intraoral, em momentos distintos de follow-up, entre os
quais: T0 (antes da extração dentária); T1 (um mês após a colocação do implante); T2
(quatro meses após colocação do implante); e T3 (um ano após a colocação do implante).
As imagens obtidas permitiram levar a cabo uma análise volumétrica e linear, de cariz
digital, que avaliou as alterações dimensionais que ocorreram nos alvéolos tratados.
Previamente á colocação do implante dentário, a realização de uma tomografia
computorizada permitiu diagnosticar o defeito associado à cortical vestibular.
Resultados
Participaram neste estudo 7 pacientes com idade média de 53,00±17,66 (variação de 27 a
77 anos), tratados com 7 implantes imediatos unitários. Durante o período de seguimento,
6 pacientes foram observados após o primeiro mês de tratamento, 4 foram estudados aos
4 meses após a colocação do implante e 3 cumpriram o controlo pós-operatório
estabelecido aos 12 meses após a cirurgia. Foi observada uma variação dos valores médios
totais com perda volumétrica de 46,1±34,8 mm3 (T0-T1), 30,7±42,3 mm3 (T0-T2) e 70±0,65
mm3 (T0-T3). Relativamente às alterações dos tecidos peri-implantares lineares vestíbulopalatinos foram observados valores médios de perda de 0,94±0,65 mm (T0-T1), 0,6±0,62
mm (T0-T2) e 0,89 ±0,60mm (T0-T3). Quanto à variação da altura da mucosa peri-implantar
obtivemos valores médios de perda a nível da papila mesial de 0,62±0,55mm, 0,64±0,53mm
ao nível da papila distal e 0,72±0,62mm ao nível da margem gengival, após um ano de
seguimento.
Conclusão
Os resultados clínicos obtidos demonstram que esta técnica a pode ser uma valiosa opção
de tratamento mediante certas condições clínicas, biótipo gengival espesso e ausência de
doença periodontal.
Introduction There are several surgical techniques for alveolar preservation, among which stands out the Tarnow technique, better known as "Ice Cream Cone", used in type II sockets, where the vestibular cortical is partially reduced after tooth extraction. The aim of this study is to determine the dimensional alterations that occurred in type II sockets, rehabilitated with immediate implants and with the "Ice Cream Cone" technique for buccal bone plate reconstruction. Materials and Methods The present study was a retrospective observational analysis of immediate post-extraction implants placed in the anterior maxillary sector, that presented some type of bone defect associated with vestibular cortical bone. The patients were submitted to an intraoral optical scanner (Cerec Omnicam®, Sirona Dental Systems GmbH, Bensheim, Germany), at different folow-up moments, which were: T0 (before tooth extraction); T1 (one month after implant placement); T2 (four months after implant placement); and T3 (one year after implant placement). The digital analysis protocol was performed as described in the literature and measurements of the linear and volumetric changes that occurred were conducted. A tomographic scan was conducted previously to the surgical procedure, so the dehiscence of the buccal cortical plate could be diagnosed. Results Seventy patients with a mean age of 53.00±17.66 (ranging from 27 to 77 years), treated with 7 immediate unit implants, participated in this study. During the follow-up period, 6 patients were observed after the first month of treatment, 4 were studied at 4 months after implant placement and 3 fulfilled the postoperative control established at 12 months after surgery. A variation of the total mean values with volumetric loss of 46.1 ±34.8mm3 (T0-T1), 30.7 ±42.3 mm3 (T0-T2) and 70±0.65 mm3 (T0-T3) were observed. Regarding changes in vestibule-palatine linear peri-implant tissues, mean loss values of 0.94±0.65 mm (T0-T1), 0.6 ±0.62 mm (T0-T2) and 0.89 ±0.60mm (T0-T3) were observed. The variation in the height of the peri-implant mucosa obtained mean loss values at the level of the mesial papilla of 0,62±0,55mm, 0,64±0,53mm at the level of the distal papilla and 0,72±0,62mm at the level of the gingival margin, during the first year of follow-up period. Conclusion The clinical results obtained demonstrate that this technique can be a valuable treatment option due to certain clinical conditions such has thick gingival biotype and absence of periodontal disease.
Introduction There are several surgical techniques for alveolar preservation, among which stands out the Tarnow technique, better known as "Ice Cream Cone", used in type II sockets, where the vestibular cortical is partially reduced after tooth extraction. The aim of this study is to determine the dimensional alterations that occurred in type II sockets, rehabilitated with immediate implants and with the "Ice Cream Cone" technique for buccal bone plate reconstruction. Materials and Methods The present study was a retrospective observational analysis of immediate post-extraction implants placed in the anterior maxillary sector, that presented some type of bone defect associated with vestibular cortical bone. The patients were submitted to an intraoral optical scanner (Cerec Omnicam®, Sirona Dental Systems GmbH, Bensheim, Germany), at different folow-up moments, which were: T0 (before tooth extraction); T1 (one month after implant placement); T2 (four months after implant placement); and T3 (one year after implant placement). The digital analysis protocol was performed as described in the literature and measurements of the linear and volumetric changes that occurred were conducted. A tomographic scan was conducted previously to the surgical procedure, so the dehiscence of the buccal cortical plate could be diagnosed. Results Seventy patients with a mean age of 53.00±17.66 (ranging from 27 to 77 years), treated with 7 immediate unit implants, participated in this study. During the follow-up period, 6 patients were observed after the first month of treatment, 4 were studied at 4 months after implant placement and 3 fulfilled the postoperative control established at 12 months after surgery. A variation of the total mean values with volumetric loss of 46.1 ±34.8mm3 (T0-T1), 30.7 ±42.3 mm3 (T0-T2) and 70±0.65 mm3 (T0-T3) were observed. Regarding changes in vestibule-palatine linear peri-implant tissues, mean loss values of 0.94±0.65 mm (T0-T1), 0.6 ±0.62 mm (T0-T2) and 0.89 ±0.60mm (T0-T3) were observed. The variation in the height of the peri-implant mucosa obtained mean loss values at the level of the mesial papilla of 0,62±0,55mm, 0,64±0,53mm at the level of the distal papilla and 0,72±0,62mm at the level of the gingival margin, during the first year of follow-up period. Conclusion The clinical results obtained demonstrate that this technique can be a valuable treatment option due to certain clinical conditions such has thick gingival biotype and absence of periodontal disease.
Description
Keywords
Implantes Imediatos Pós-extracional Zona anterior Immediate implant Extraction socket Anterior zone