Complicações precoces em próteses parciais fixas implantossuportadas de zircônia monolítica e bicamada: estudo prospectivo, randomizado, de boca dividida.
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Data
2021-11-29
Autores
Moreno, Jéssica Monique Lopes [UNESP]
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Editor
Universidade Estadual Paulista (Unesp)
Resumo
As coroas de cerâmica pura ganharam força na odontologia uma vez que as exigências estéticas e mecânicas são cada vez mais evidentes. As próteses metal free do tipo bicamada, não raramente, apresentam lascamento da cerâmica de cobertura como a principal falha em longo prazo. Logo, iniciou-se o uso de próteses cerâmicas monolíticas. Paralelamente, são crescentes a busca e o uso de implantes osseointegráveis para suportar as reabilitações orais, sendo a primeira opção para as reabilitações de áreas edêntulas parciais. Assim, o objetivo deste estudo clínico prospectivo, randomizado de boca dividida foi avaliar o desempenho clínico e a previsibilidade, caracterizando o número e o tipo de complicações e falhas precoces, como desgaste do antagonista, perda óssea marginal, inflamação gengival e falhas mecânicas que possam ocorrer em PPFs de três elementos implantossuportadas de zircônia monolítica e infraestrutura de zircônia com cerâmica de cobertura, com retenção mista em região posterior de mandíbula, além de avaliar a percepção estética e satisfação do paciente com cada uma delas. Os pacientes selecionados (n=2) passaram por procedimentos cirúrgicos para instalação de dois implantes na região posterior de mandíbula, sendo dois de cada lado. Após seis meses os cicatrizadores foram instalados e a moldagem realizada para confecção das próteses seguindo a aleatorização do lado da mandíbula. Foi avaliado desgaste das próteses e dos antagonistas por meio de imagens em microscopia eletrônica de varredura; perda óssea periimplantar utilizando radiografias periapicais em três períodos, antes da instalação das próteses, imediatamente e três meses após a instalação, percepção estética e alteração de cor utilizando o método de escala visual analógica pelo paciente. As hipóteses deste estudo são que a resistência à fratura e lascamento será semelhante nos grupos avaliados, todos os grupos serão esticamente aceitáveis, o desgaste do antagonista e das próteses será semelhante entre os grupos, assim como a manutenção periodontal e nível de perda óssea.
The pure ceramic crowns have been gaining strength in dentistry since the aesthetic and mechanical requirements are increasingly evident. Since free metal dentures of the bilayer type, not infrequently, show sputtering of the ceramic cover as the main long-term failure, the use of monolithic prostheses was started. At the same time, the search for and use of osseointegratable implants to support partial rehabilitation is increasing, being the first option for oral rehabilitation of edentulous areas. Therefore, the purpose of this prospective, randomized, split-mouth clinical study is to assess clinical performance and predictability, characterizing the number and type of early complications and failures such as antagonist wear, bone loss, gingival inflammation, and mechanical failures that may occur in PPFs of three implant - supported elements with mixed retention in posterior region of mandible in monolithic zirconia, zirconia infrastructure with covering ceramics and metaloceramics, besides evaluating aesthetic perception and patient satisfaction with each one. Patients selected (n = 8) will undergo surgical procedures to install two implants in the posterior mandible, two on each side. After three to four months the healing will be installed and the molding will be performed to make the prosthesis following the randomization of both the patients and the side of the jaw. Wear of prostheses and antagonists will be assessed by scanning electron microscopy and profilometry; bone loss peri-implant using periapical radiographs in seven periods, immediately after the implant installation, 7 days after surgery, before the installation of the healers, at the installation of the prosthesis, 21 days after, six and twelve months later, aesthetic perception and color change using the method of visual analog scale by the patient and an intraoral spectophotometer. The hypotheses of this study are resistance to fracture and chipping will be similar in the evaluated groups, all groups will be ethically acceptable, the wear of the antagonist and the prostheses will be similar between groups and the periodontal maintenance and level of bone loss will be similar for the groups.
The pure ceramic crowns have been gaining strength in dentistry since the aesthetic and mechanical requirements are increasingly evident. Since free metal dentures of the bilayer type, not infrequently, show sputtering of the ceramic cover as the main long-term failure, the use of monolithic prostheses was started. At the same time, the search for and use of osseointegratable implants to support partial rehabilitation is increasing, being the first option for oral rehabilitation of edentulous areas. Therefore, the purpose of this prospective, randomized, split-mouth clinical study is to assess clinical performance and predictability, characterizing the number and type of early complications and failures such as antagonist wear, bone loss, gingival inflammation, and mechanical failures that may occur in PPFs of three implant - supported elements with mixed retention in posterior region of mandible in monolithic zirconia, zirconia infrastructure with covering ceramics and metaloceramics, besides evaluating aesthetic perception and patient satisfaction with each one. Patients selected (n = 8) will undergo surgical procedures to install two implants in the posterior mandible, two on each side. After three to four months the healing will be installed and the molding will be performed to make the prosthesis following the randomization of both the patients and the side of the jaw. Wear of prostheses and antagonists will be assessed by scanning electron microscopy and profilometry; bone loss peri-implant using periapical radiographs in seven periods, immediately after the implant installation, 7 days after surgery, before the installation of the healers, at the installation of the prosthesis, 21 days after, six and twelve months later, aesthetic perception and color change using the method of visual analog scale by the patient and an intraoral spectophotometer. The hypotheses of this study are resistance to fracture and chipping will be similar in the evaluated groups, all groups will be ethically acceptable, the wear of the antagonist and the prostheses will be similar between groups and the periodontal maintenance and level of bone loss will be similar for the groups.
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Palavras-chave
Desgaste do antagonista, Implantes Dentários, Monolíticas, Prótese dentária fixada por implante, Zircônio, Dental implants