Protocolo de reabilitação bucal com inserção imediata de implante cone morse e prótese provisória unitária em alvéolos após exodontia

• Autor(a) principal: Cauduro, Fernando Santos
• Data de Publicação: 2009
• Tipo de documento: Tese
• Idioma: por
• Título da fonte: Repositório Institucional PUCRS
• Texto Completo: http://hdl.handle.net/10923/402
• topic: ODONTOLOGIA; IMPLANTODONTIA; PRÓTESE DENTÁRIA; IMPLANTES DENTÁRIOS OSSEOINTEGRADOS

The present study describes a protocol for oral rehabilitation by means of osseointegrated implants with taper connection and installation of a provisional prosthesis, immediately after exodontia, and evaluates retrospectively, through the analysis of patient charts and complementary examinations, the result of the protocol instituted, for a postoperative follow-up period of up to five years. Fifty-seven consecutive patients, treated in the private clinic, were submitted to oral rehabilitation using a protocol for the insertion of an Ankylos® implant with a taper connection and the installation of a single provisional crown, immediately after exodontia. The protocol is characterized by its rapid and minimally traumatic surgical techniques, in which exodontia is performed without incision or mucoperiosteal detachment, only syndesmotomy, thereby dispensing with sutures; also, the immediate provisional crown effaces the alveolar opening, keeping the blood clot stable. The protocol does not recommend the use of grafts or other bone substitute biomaterials, nor the use of membranes for guided bone regeneration. The data on periimplantar tissue behavior with the application of the proposed protocol were collected and submitted to statistical analysis, where they were presented using tables, graphs, descriptive statistics (means and standard deviation) and statistical tests (Kolmogorov- Smirnov test, Fisher‟s exact test, analysis of variance-ANOVA, Tukey‟s test, and Kruskal- Wallis test) in the comparison or correlation between the variables related to the insertion protocol and to the postoperative clinical and radiographic characteristics. The success rate of the treatment was 98. 25% (56 implants), where there was a loss of one implant (1. 75%). The protocol appears to be reliable according to the clinical and radiographic results recorded in the patient charts. It is recommended to establish a surgical area with support in the palatine wall, mesial and distal, avoiding intentionally the vestibular wall and not following the orientation of the original alveolus. Implants of smaller diameter are utilized, provided that initial stability is obtained, facilitating the formation of the blood clot between the implant and vestibular alveolar wall, with the aim of filling it with neoformed bone. The taper connection implant allows the installation of the implant deeply (at least 3 mm below the bone crest), for the purpose of favoring and/or maintaining the bone neoformation at the top of the implant and consequent support for the soft tissues. In some cases, there is a discrete horizontal vestibular bone loss, resulting in the planning of the convexity of the vestibular alveolar wall, without interfering significantly with aesthetics.