RESUMO
This case series study evaluated the survival, success rate and marginal bone remodeling of Morse taper hydrophilic implants placed for full-arch rehabilitations over a 1-year follow-up period. Ten patients in need of maxillary and/or mandibular full-arch rehabilitation were selected. Sixty-six Morse taper implants and sixty-six abutments were inserted. All implants were placed using a surgical flap approach without bone regeneration and were immediately loaded with definitive prostheses according to the passive fitting technique. The patients underwent clinical and radiographic follow-up at different postoperative periods: T0 = immediate (up to 1 month after surgery); T1 = 3-4 months after surgery; T2 = 6-8 months after surgery; and T3 = 1 year after surgery. The survival and success rate of the implants and the marginal bone remodeling were evaluated. Normal distribution of the outcomes was verified by Kolmogorov-Smirnov tests. Therefore, changes in vertical and horizontal marginal bone levels were assessed with paired t-tests. Results were considered significant for P < 0.05. Survival and success rates of 100% and 92.4%, respectively, were observed. Statistically significant vertical bone level changes were shown for all periods. From T0 to T3, there was a mean difference in vertical bone loss of -1.02 mm on the mesial surface and of -0.93 mm on the distal surface, for horizontal bone loss in the same period, it was observed mean changes of -0.14 mm on the mesial surface and -0.09 mm on the distal surface. This 1-year case series follow-up of immediate full-arch rehabilitation, using one-step hybrid passive fitting supported by four to six hydrophilic tapered implants, suggests predictability with high survival and success rates in edentulous patients.
Assuntos
Remodelação Óssea , Implantes Dentários , Implantação Dentária Endóssea , Seguimentos , Humanos , Maxila , Próteses e Implantes , Resultado do TratamentoRESUMO
A instalação imediata de implantes em região estética é uma prática frequente, pois reduzir a remodelação óssea e tecidual. Os implantes com interface cone Morse apresentam resultados biológicos e estéticos satisfatórios a longo prazo, pois apresentam gap reduzido entre implante e componente protético e a interface fica distante do tecido ósseo. Este artigo tem como objetivo relatar a reabilitação estética de um incisivo central superior comprometido através da instalação de um implante cone Morse utilizando a técnica da cirurgia guiada com provisionalização imediata. Paciente com 40 anos de idade, do sexo masculino, apresentava incisivo central superior (#21) com tratamento endodôntico prévio, recessão gengival vestibular, escurecimento coronário e mobilidade. O caso clínico apresentado mostrou que, após 12 meses, resultados precisos e estéticos são possíveis de alcançar com a instalação de implantes em alvéolos pós-extração e instalação de um dente provisório imediato em regiões estéticas.
The immediate placement of implant in fresh sockets in the aesthetic area is a frequent practice as it reduces bone and tissue remodeling. Morse taper implants present satisfactory biological and aesthetic results in the long term, since they present a reduced gap between implant and prosthetic component and this interface is distant from bone. This article aims to report the aesthetic restoration of a compromised central upper incisor with the placement of a Morse taper implant using guided surgery with immediate provision. A 40-year-old male patient had a central upper incisor (#21) with previous endodontic treatment, vestibular gingival recession, coronary browning, and mobility. The clinical case presented showed that, after 12 months, precise and aesthetic results are possible to achieve with the placement of implants in post-extracting alveolus and installation of an immediate provisional tooth in esthetic regions.
RESUMO
A ancoragem de implantes em osso zigomático tem sido reconhecida como uma abordagem terapêutica menos invasiva quando comparada às grandes reconstruções para a reabilitação de maxilas severamente atróficas. Apesar de alcançar sucesso clínico elevado do ponto de vista cirúrgico e protético, melhorando a qualidade de vida e satisfação dos pacientes, problemas relacionados ao conforto da prótese são algumas vezes relacionados. Este caso clínico apresenta a resolução de 2 problemas: i) implantes zigomáticos do tipo cone morse em nível gengival, o que deixava a região côncava dos intermediários exposta ao meio oral e ii) hipersensibilidade na região de fossa nasal pela presença de implantes na região. A sensibilidade e trauma na língua, em decorrência dos implantes posteriores, foram solucionados pela personalização de um componente protético, enquanto a sensação de pressão na região anterior da maxila foi eliminada após a remoção de 2 implantes convencionais sem prejuízo à biomecânica da prótese implantossuportada (AU).
The anchorage of implants in the zygomatic bone has been recognized as a less invasive approach when compared to large reconstructions of severely atrophic maxilla. Although high rates of surgical and prosthetic success have been reached improving the patient life quality and satisfaction, problems in terms of prosthesis comfort are sometimes reported. This case report presents the resolution of 2 problems: i) morse taper zygomatic implants at the gingival level, resulting in the exposure of the concave area of the abutments and ii) hypersensitivity at the nasal cavity region, due to implants nearby this site. Sensitivity and tongue trauma, as a result of posterior implants, were solved by prosthetic component customization , while the pressure in the maxilla anterior area was eliminated after removing 2 conventional implants with no damage to the biomechanics of the implant supported prosthesis (AU).
