Utilização de tela de titânio e substituto ósseo xenógeno para reconstrução de defeito ósseo em área estética.
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Data
2020-09-29
Autores
Mendes, Larissa Raniero [UNESP]
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Editor
Universidade Estadual Paulista (Unesp)
Resumo
Lesões de origem periodontal e endodôntica podem gerar quadros de perda óssea significativa, que muitas vezes requerem cirurgias reconstrutivas para viabilizarem a instalação de implantes de titânio em posição tridimensionalmente adequada. Sendo assim, o objetivo do presente trabalho é relatar um caso de reconstrução óssea com tela de titânio e enxerto xenógeno em área estética. Paciente do gênero feminino, 42 anos de idade, compareceu na clínica de pós-graduação da FOA/UNESP e, ao exame clínico e imagiológico, foi observado comprometimento do elemento 21, associado a extensa reabsorção óssea. Um retalho total com incisões relaxantes verticais na região mesial do 21 e distal do 22 foi confeccionado. O dente 21 foi extraído e a lesão curetada. Com o tecido ósseo exposto, o leito receptor foi preparado. Após estabilização da tela com parafusos na região vestibular, o substituto xenógeno foi colocado no defeito e a tela adaptada sobre ele. Foi colocado um parafuso por palatino e feitas duas suturas sobre a tela. Em seguida, foi removido enxerto de tecido conjuntivo do palato e suturado sobre a tela. O retalho foi reposicionado e mantido em posição por meio de suturas. Foi feito acompanhamento clínico e radiográfico da paciente, sendo que nenhuma intercorrência foi observada durante o período de reparo. Após 8 meses da cirurgia, foi observada excelente qualidade do tecido mole da região, bem como, ao remover a tela, foi observado grande volume de tecido ósseo na área, para instalação adequada do implante. Assim sendo, pode-se concluir que a regeneração óssea com tela de titânio e substituto xenógeno, combinado com enxerto de tecido conjuntivo, foi capaz de promover ganho de volume ósseo, previsibilidade e ótima qualidade do tecido mole da região, favorecendo a reconstrução tridimensional em áreas com restrição óssea.
Lesions of periodontal and endodontic origin can generate significant bone loss, which often require reconstructive surgery to enable the installation of titanium implants in a three-dimensionally adequate position. Thus, the objective of the present work is to report a case of bone reconstruction with titanium mesh and xenogenous graft in the aesthetic area. A 42-year-old female patient attended the post-graduation clinic at FOA/UNESP and, on clinical and imaging examination, element 21 involvement was observed, associated with extensive bone resorption. A total flap with vertical relaxing incisions in the mesial region of the 21 and distal region of the 22 was made. Tooth 21 was extracted and the lesion cured. With the exposed bone tissue, the recipient bed was prepared. After stabilizing the screen with screws in the vestibular, the xenogeny substitute was placed in the defect and the screen was adapted over it. One palatal screw was placed, and two sutures were made over the mesh. Then, a connective tissue graft was removed from the palate and sutured over the mesh. The flap was repositioned and held in place by means of sutures. Clinical and radiographic follow-up of the patient was carried out, and no complications were observed during the repair period. After 8 months of surgery, excellent quality of the soft tissue in the region was observed, and following removal of the mesh, a large volume of bone tissue was observed in the area, for proper implant installation. Therefore, it can be concluded that bone regeneration with titanium mesh and xenogeny substitute, combined with connective tissue graft, was able to promote bone volume gain, predictability and excellent quality of the region’s soft tissue, favoring three-dimensional reconstruction in areas with bone restriction.
Lesions of periodontal and endodontic origin can generate significant bone loss, which often require reconstructive surgery to enable the installation of titanium implants in a three-dimensionally adequate position. Thus, the objective of the present work is to report a case of bone reconstruction with titanium mesh and xenogenous graft in the aesthetic area. A 42-year-old female patient attended the post-graduation clinic at FOA/UNESP and, on clinical and imaging examination, element 21 involvement was observed, associated with extensive bone resorption. A total flap with vertical relaxing incisions in the mesial region of the 21 and distal region of the 22 was made. Tooth 21 was extracted and the lesion cured. With the exposed bone tissue, the recipient bed was prepared. After stabilizing the screen with screws in the vestibular, the xenogeny substitute was placed in the defect and the screen was adapted over it. One palatal screw was placed, and two sutures were made over the mesh. Then, a connective tissue graft was removed from the palate and sutured over the mesh. The flap was repositioned and held in place by means of sutures. Clinical and radiographic follow-up of the patient was carried out, and no complications were observed during the repair period. After 8 months of surgery, excellent quality of the soft tissue in the region was observed, and following removal of the mesh, a large volume of bone tissue was observed in the area, for proper implant installation. Therefore, it can be concluded that bone regeneration with titanium mesh and xenogeny substitute, combined with connective tissue graft, was able to promote bone volume gain, predictability and excellent quality of the region’s soft tissue, favoring three-dimensional reconstruction in areas with bone restriction.
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Palavras-chave
Titânio, Substitutos ósseos, Bone substitutes