Influência da colocação de enxerto de tecido conjuntivo ao redor de implantes instalados em áreas estéticas: estudo clínico controlado e randomizado
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Data
2017-06-07
Autores
Lazzari, Thiago Rodrigues [UNESP]
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Editor
Universidade Estadual Paulista (Unesp)
Resumo
Os implantes dentários têm sido utilizados desde meados da década de 50, e inúmeros estudos garantem a confiabilidade para sua utilização, dessa forma o implante tem se tornado uma prática comum entre os cirurgiões dentistas. À medida que sua utilização vem crescendo, suas complicações também aumentaram, principalmente quando instalados em áreas estéticas, onde há deficiência de tecido conjuntivo perimplantar. O objetivo deste estudo clínico controlado randomizado foi avaliar o aumento do volume de tecido conjuntivo perimplantar em implantes instalados em áreas estéticas com a utilização de enxerto de tecido conjuntivo. Para este estudo, foi utilizada uma amostra de 42 indivíduos com necessidade de implantes em áreas estéticas, onde o grupo teste (n=20) recebeu enxerto de tecido conjuntivo sobre os implantes e o grupo controle (n=22) recebeu apenas o implante dental sem a colocação de enxerto de tecido conjuntivo. Para análise do aumento do tecido perimplantar foram realizadas medidas clínicas no baseline, trans-operatório e pós-operatório de 4 meses. Após 4 meses o grupo teste apresentou diferença significativa no aumento de tecido conjuntivo, uma média 3,35±1,08mm / 3,62±1,08mm na vestibular e sobre o rebordo respectivamente, quando comparado ao grupo controle 2,08±0,62mm/ 2,51±0,53mm na vestibular e sobre o rebordo respectivamente. Houve diferença significativa na diminuição da deiscência óssea vestibular para o grupo teste uma média de 0,4±0,8mm contra 1,0±0,8mm do grupo controle (p<0,05). Não houve diferença significativa quanto a dor relatada pelos pacientes e a quantidade de analgésicos ingeridos. Pode-se concluir que após 4 meses o grupo teste apresentou aumento no volume de tecido conjuntivo, diminuição da deiscência óssea vestibular e os pacientes do grupo teste não sentiram uma dor maior que o grupo controle.
Dental implants have been used since 1950, and as numerous studies ensure reliability for its use, they implant have become a common practice among dentists. However , complications have also risen from its increased application, especially when they are installed in esthetic areas, where there is deficiency of periimplant soft tissue. The purpose of this randomized controlled trial was to evaluate the increase in volume periimplantar soft tissue esthetic areas with the use of connective tissue graft. Individuals in need of implants in esthetic areas were included, and divided in two groups: test group (n = 20) received a tissue graft over the implants and the control group (n = 22) received only dental implant without the connective tissue graft placement. For the analysis of periimplantar tissue augmentation, baseline, trans-operative and postoperative measurements were performed. After 4 months, the test group presented a significant difference in mean connective tissue augmentation, with 3.35 ± 1.08 mm in the vestibular area and 3.62 ± 1.08 mm on the ridge when compared to the control group, with 2.08 ± 0 62 mm in the vestibular area and 2.51 ± 0.53mm on the ridge. There was a significant difference in the reduction of vestibular bone dehiscence for the test group, with a mean of 0.4 ± 0.8 mm versus 1.0 ± 0.8 mm in the control group (p <0.05). There was no significant difference in pain reported by patients and the amount of post-operative analgesics ingested taken. It can be concluded that after 4 months the use of connective tissue graft test group resulted in an increase in connective tissue volume, decreased vestibular bone dehiscence with similar amount of post-operative pain than the control group.
Dental implants have been used since 1950, and as numerous studies ensure reliability for its use, they implant have become a common practice among dentists. However , complications have also risen from its increased application, especially when they are installed in esthetic areas, where there is deficiency of periimplant soft tissue. The purpose of this randomized controlled trial was to evaluate the increase in volume periimplantar soft tissue esthetic areas with the use of connective tissue graft. Individuals in need of implants in esthetic areas were included, and divided in two groups: test group (n = 20) received a tissue graft over the implants and the control group (n = 22) received only dental implant without the connective tissue graft placement. For the analysis of periimplantar tissue augmentation, baseline, trans-operative and postoperative measurements were performed. After 4 months, the test group presented a significant difference in mean connective tissue augmentation, with 3.35 ± 1.08 mm in the vestibular area and 3.62 ± 1.08 mm on the ridge when compared to the control group, with 2.08 ± 0 62 mm in the vestibular area and 2.51 ± 0.53mm on the ridge. There was a significant difference in the reduction of vestibular bone dehiscence for the test group, with a mean of 0.4 ± 0.8 mm versus 1.0 ± 0.8 mm in the control group (p <0.05). There was no significant difference in pain reported by patients and the amount of post-operative analgesics ingested taken. It can be concluded that after 4 months the use of connective tissue graft test group resulted in an increase in connective tissue volume, decreased vestibular bone dehiscence with similar amount of post-operative pain than the control group.
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Palavras-chave
Implante, Enxerto de tecido conjuntivo, Áreas estéticas, Implant, Connective tissue graft, Esthetic areas