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Autores
Resumo(s)
Introdução
A colocação de implantes imediatos pós extracionais é uma modalidade
de tratamento frequente na prática clínica, sendo objeto de estudo os processos
que estão envolvidos na cicatrização do alvéolo, tendo em conta que a
inevitabilidade dos fenómenos remodeladores fisiológicos após a extração
dentária podem resultar em alterações significativas do osso alveolar.
O objetivo deste estudo é comparar as diferenças clínicas determinadas
através das alterações tecidulares entre dois tipos de selamento de alvéolos
após a colocação de um implante imediato na arcada maxilar, ao longo de dois
anos de tratamento.
Materiais e Métodos
O presente estudo seguiu uma metodologia de estudo clínico prospetivo,
controlado, randomizado com paralelismo de grupos de teste. O protocolo de
tratamento foi dividido aleatoriamente de acordo com a técnica de fechamento
do alvéolo utilizada. Assim, no grupo I foram alocados os pacientes que tiveram
o alvéolo pós extracional selado com uma matriz reabsorvível de colagénio
suturada através de sutura simples interrompidas com fio de poliamida 6/0 á
mucosa alveolar adjacente; os pacientes do grupo II receberam um pilar de
cicatrização customizado, sem necessidade de suturas. Todos os pacientes
foram reabilitados protética e provisoriamente, com coroa do tipo Maryland. Após
dez dias do procedimento cirúrgico, as suturas do grupo I foram removidas e
agendados os controlos pós-operatórios, que incluíram visitas a um (T1), quatro
(T2), doze (T3) e vinte e quatro (T4) meses após a colocação do implante. Os
modelos digitais da arcada em questão correspondentes a T1, T2, T3 e T4 foram
exportados do software do scanner ótico intraoral utilizado em formato STL e
importados para o programa informático, seguindo o protocolo de análise de
modelos já publicados. Os valores médios foram comparados e a significância
estatística foi estabelecida a 0,05.
X
Resultados
Participaram neste estudo 34 pacientes, com idade média de 53,38±11,46
anos.. No grupo I, a maioria das alterações dos tecidos ocorreram durante o
primeiro (T0-T1), quarto (T0-T2) e décimo segundo mês de observação (T0-T3) em
comparação com os vinte quatro meses (T0-T4). Estes resultados não têm
significância quando a 1 ano de seguimento em relação as variações das
medições lineares como das volumétricas. Relativamente à variação do volume
vestibular, as alterações ocorridas nos dois anos de seguimento (T0-T4) os
indivíduos do grupo I registavam uma perda média de -8,53%±6,51 e os
indivíduos do grupo II de -12,00%±7,09, verificando-se diferenças significativas
entre os dois grupos.
Conclusão
O grupo de pacientes que receberam a membrana de colagénio tem resultados
favoráveis ao longo dos dois anos de tratamento na manutenção dos tecidos
peri-implantares em relação ao grupo de recebeu o pilar customizado.
Introduction The placement of immediate post-extraction implants is a frequent treatment modality in clinical practice, and the processes that are involved in the healing of the alveolar are being investigated, taking into account that the inevitability of physiological remodeling phenomena after tooth extraction can result in significant changes in alveolar bone. The aim of this study is to compare the clinical differences determined through tissue changes between two types of alveolar sealing after placement of an immediate implant in the maxillary arch over two years of treatment. Materials and Methods The present study followed a methodology of prospective, controlled, randomized clinical study with parallelism of test groups. The treatment protocol was randomly divided according to the alveolus closure technique used. Thus, in group I, patients who had the post-extractional alveolus sealed with a reabsorbable matrix of collagen sutured through a simple suture interrupted with polyamide thread 6/0 to the adjacent alveolar mucosa were allocated; patients in group II received a customized healing abutment, without the need for sutures. All patients were rehabilitated prostheticly and provisionally, with Maryland crown type. Ten days after the surgical procedure, the sutures of group I were removed and scheduled the postoperative controls, which included visits to one (T1), four (T2), twelve (T3) and twenty-four (T4) months after implant insertion. The digital models of the arch in question corresponding to T1, T2, T3 and T4 were exported from the intraoral optical scanner software used in STL format and imported into the computer program, following the analysis protocol of already published models. The mean values were compared and the statistical significance was established at 0.05. Results Thirty-four patients participated in this study, with a mean age of 53.38±11.46 years. No patient was diagnosed with periodontal disease during the 24-month follow-up period. In group I, most tissue changes occurred during the first (T0-T1), fourth (T0-T2) and twelfth month of observation (T0-T3) in comparison with twenty-four months (T0-T4). These results are not significant to XII a 1 year of follow-up in relation to variations in linear measurements and volumetric measurements. Regarding the variation in vestibular volume, the alterations occurred in the two years of follow-up (T0-T4) individuals in group I had an average loss of -8.53%±6.51 and individuals in group II of -12.00%±7.09, with significant differences between the two groups. Conclusion The group of patients who received the collagen membrane had favorable results over the two years of treatment in the maintenance of peri-implant tissues in relation to the customized abutment.
Introduction The placement of immediate post-extraction implants is a frequent treatment modality in clinical practice, and the processes that are involved in the healing of the alveolar are being investigated, taking into account that the inevitability of physiological remodeling phenomena after tooth extraction can result in significant changes in alveolar bone. The aim of this study is to compare the clinical differences determined through tissue changes between two types of alveolar sealing after placement of an immediate implant in the maxillary arch over two years of treatment. Materials and Methods The present study followed a methodology of prospective, controlled, randomized clinical study with parallelism of test groups. The treatment protocol was randomly divided according to the alveolus closure technique used. Thus, in group I, patients who had the post-extractional alveolus sealed with a reabsorbable matrix of collagen sutured through a simple suture interrupted with polyamide thread 6/0 to the adjacent alveolar mucosa were allocated; patients in group II received a customized healing abutment, without the need for sutures. All patients were rehabilitated prostheticly and provisionally, with Maryland crown type. Ten days after the surgical procedure, the sutures of group I were removed and scheduled the postoperative controls, which included visits to one (T1), four (T2), twelve (T3) and twenty-four (T4) months after implant insertion. The digital models of the arch in question corresponding to T1, T2, T3 and T4 were exported from the intraoral optical scanner software used in STL format and imported into the computer program, following the analysis protocol of already published models. The mean values were compared and the statistical significance was established at 0.05. Results Thirty-four patients participated in this study, with a mean age of 53.38±11.46 years. No patient was diagnosed with periodontal disease during the 24-month follow-up period. In group I, most tissue changes occurred during the first (T0-T1), fourth (T0-T2) and twelfth month of observation (T0-T3) in comparison with twenty-four months (T0-T4). These results are not significant to XII a 1 year of follow-up in relation to variations in linear measurements and volumetric measurements. Regarding the variation in vestibular volume, the alterations occurred in the two years of follow-up (T0-T4) individuals in group I had an average loss of -8.53%±6.51 and individuals in group II of -12.00%±7.09, with significant differences between the two groups. Conclusion The group of patients who received the collagen membrane had favorable results over the two years of treatment in the maintenance of peri-implant tissues in relation to the customized abutment.
Descrição
Palavras-chave
Implantes dentários Perda óssea alveolar Tecidos peri-implantares Análise volumétrica Pilar de cicatrização customizado Dental implants Alveolar bone loss Peri-implant tissues Volumetric analysis Customized healing abutment