Avaliação dos tecidos peri-implantares: estudos clínicos
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Data
2018-03-29
Autores
Nícoli, Lélis Gustavo
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Editor
Universidade Estadual Paulista (Unesp)
Resumo
O objetivo do presente estudo foi investigar a ocorrência das doenças peri-implantares e a influência de possíveis fatores de risco utilizando duas abordagens metodológicas diferentes. Inicialmente realizou-se um estudo retrospectivo para avaliar a sobrevivência e o sucesso de implantes com superfície tratada com ataque ácido após 8 a 10 anos de função. Quarenta e quatro pacientes e 183 implantes foram incluídos. Dados demográficos, sistêmicos e comportamentais foram obtidos seguidos da avaliação clínica periodontal, peri-implantar e radiográfica realizados em uma única sessão. Nesse estudo relatou-se, nos 183 implantes avaliados, um índice de sobrevivência e sucesso de 97,3% e 84,7%, respectivamente. Dos implantes sobreviventes, 51% apresentavam mucosite e 11% peri-implantite. Posteriormente investigou-se, em um estudo prospectivo, a incidência de mucosite e perda óssea peri-implantar após 1 ano em função. Foram incluídos 56 pacientes totalizando 180 implantes. O exame clínico periodontal e peri-implantar seguido de radiografias periapicais padronizadas foi realizado 15 dias após a instalação das próteses e após 3, 6 e 12 meses de função. Com essa abordagem, observou-se uma incidência de 44,8% de mucosite peri-implantar, porém nenhum caso de peri-implantite foi observado nos 180 implantes avaliados. Implantes com conexão hexagono interno apresentaram incidência de mucosite significativamente maior após 1 ano de acompanhamento. Ademais, uma média de perda óssea peri-implantar de 0.35 ± 1.89 mm foi observada, porém nenhum dos fatores relacionados ao paciente/implante investigados nesse estudo foram associados a perda óssea marginal. Em conclusão, implantes com superfície tratada com ataque ácido apresentam alto índice de sucesso e sobrevivência após 8 a 10 anos de acompanhamento. Implantes com conexões do tipo hexágono interno apresentaram maior incidênciad de mucosite após 1 ano de acompanhamento. Além disto, não houve influência dos fatores relacionados ao paciente e/ou aos implantes e a perda óssea peri-implantar nesse estudo.
The purpose of this investigation was to assess the incidence of peri-implant diseases and how they can be associated to possible risk factors. Two different approaches were addressed. Through a retrospective study, survival and success rates of implants with acid-etched-treated surface were initially evaluated in 44 patients, with 183 implants, in function for 8 to 10 years. Analysis included demographic, systemic and behavioral data, followed by one-session radiographic, periodontal and peri-implant clinical evaluations. This first study yielded survival and success rates of 97.3% and 84.7%, respectively, for the 183 investigated implants. Among the surviving implants, 51% were affected by mucosite and 11%, by peri-implantitis. A second study was also carried out to prospectively investigate mucosite incidence as well as peri-implantar bone loss in 180 implants, placed in 56 patients, after 1 year of function, which were assessed by clinical periodontal and peri-implant examinations, followed by standardized peri-apical radiographs, carried out 15 days after installation of the prosthesis, and at 3, 6 and 12 months of function. This observation revealed a 44.8% rate of peri-implant mucosite; however, no case of peri-implantitis was found. Implants with an intern-hexagon platform were significantly more affected by mucositis after one year of observation. In addition, a mean peri-implant bone-loss of 0.35 ± 1.89 mm was detected, however none of the patient or implant-related factors could be associated to this marginal bone loss. In conclusion, implants with acid-etched-treated surface showed high survival and success rates after 10 years of function. Implants with an intern-hexagon platform showed a higher rate of mucositis after one year of observation; and no relation was established between the patient or implant-related factors and the marginal bone loss found in this study.
The purpose of this investigation was to assess the incidence of peri-implant diseases and how they can be associated to possible risk factors. Two different approaches were addressed. Through a retrospective study, survival and success rates of implants with acid-etched-treated surface were initially evaluated in 44 patients, with 183 implants, in function for 8 to 10 years. Analysis included demographic, systemic and behavioral data, followed by one-session radiographic, periodontal and peri-implant clinical evaluations. This first study yielded survival and success rates of 97.3% and 84.7%, respectively, for the 183 investigated implants. Among the surviving implants, 51% were affected by mucosite and 11%, by peri-implantitis. A second study was also carried out to prospectively investigate mucosite incidence as well as peri-implantar bone loss in 180 implants, placed in 56 patients, after 1 year of function, which were assessed by clinical periodontal and peri-implant examinations, followed by standardized peri-apical radiographs, carried out 15 days after installation of the prosthesis, and at 3, 6 and 12 months of function. This observation revealed a 44.8% rate of peri-implant mucosite; however, no case of peri-implantitis was found. Implants with an intern-hexagon platform were significantly more affected by mucositis after one year of observation. In addition, a mean peri-implant bone-loss of 0.35 ± 1.89 mm was detected, however none of the patient or implant-related factors could be associated to this marginal bone loss. In conclusion, implants with acid-etched-treated surface showed high survival and success rates after 10 years of function. Implants with an intern-hexagon platform showed a higher rate of mucositis after one year of observation; and no relation was established between the patient or implant-related factors and the marginal bone loss found in this study.
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Palavras-chave
Implantes dentários, Osseointegração, Peri-implantite, Dental implants, Osseointegration, Peri-implantitis