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Publication
Clinical outcome of oral implants rehabilitations in patients with and without mechanical complications : a comparative study
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Abstract(s)
Enquadramento: Apesar das elevadas taxas de sucesso, os implantes dentários não estão isentos de complicações. A ocorrência de complicações mecânicas, pode ser uma fonte de frustração, não só para o doente, mas também para o clínico. A relação entre a presença destas complicações e os outcomes clínicos, não é clara.
Objetivo: Estudar o impacto das complicações mecânicas na sobrevivência do implante, na reabsorção óssea marginal e na incidência de complicações biológicas.
Materiais e Métodos: Este estudo caso-controlo incluiu um total de 564 participantes, divididos em dois grupos: doentes reabilitados com próteses implanto-suportadas, com implantes com carga imediata, com registo de ocorrência de complicações mecânicas (n=282) e um grupo controlo submetido ao mesmo tipo de intervenção sem a ocorrência de complicações mecânicas (n=282), recorrendo a uma base de dados. O emparelhamento
foi feito relativamente ao sexo, idade (intervalo etário de 3 anos) e follow-up. O outcome primário foi a sobrevivência do implante, avaliada com base na função do mesmo como unidade de uma reabilitação protética; os outcomes secundários foram: nível de osso marginal e parâmetros de complicações biológicas (patologia peri-implantar, inflamação os tecidos moles, formação de fistula, formação de abcesso).
Resultados: A média de meses de follow-up foi 90 meses. A taxa de sucesso foi de 100% nos casos e 99.6%, controlos (p=0.317). A média de perda óssea foi de 1.72 (95% IC: 1.60; 1.84) para os casos e 1.55 (95% IC: 1.45; 1.65) para os controlos (p=0.068). Foram registadas complicações biológicas em 98 doentes (62 nos casos e 36 nos controlos, p=0.004), sendo que a maioria foram patologias peri-implantares (n=86).
Conclusões: Sem evidências que a ocorrência de complicações mecânicas tenha influência na sobrevivência do implante. Apesar de os resultados sugerirem que não tem influência na perda óssea marginal, outros estudos com maior follow-up são necessários.
A incidência de complicações biológicas, nomeadamente doenças peri-implantares, é maior em doentes com registo de complicações mecânicas.
Background: Despite the high success rates, dental implants are not free from complications. The occurrence of mechanical complication can be a source of frustration not only for the patient but also for the clinician. The relationship between the presence of these complications and clinical outcomes is unclear. Objective: The aim of this study was to investigate the impact of mechanical complications on the outcome measures for implant success: survival, marginal bone resorption and incidence of complications Materials and methods: This case control study included a total of 564 patients, divided into two groups: 282 patients identified with mechanical complications occurring in the fixed prosthetic rehabilitations supported by immediate function implants, and a control group. Pairing was done for gender, age (within a range of 3 years) and months of follow-up. Primary outcome measures were implant survival, evaluated based on function of the implant as part of a prosthetic rehabilitation unit; secondary outcome measures were marginal bone level and biological complication parameters (peri-implant pathology, soft tissue inflammation, fistula formation, abscess formation). Results: The average follow-up was 90 months. The success rate was 100% and 99.6% for cases and controls, respectively (p=0.317). The average marginal bone loss was 1.72 (95% CI: 1.60; 1.84) for cases and 1.55 (95% CI: 1.45; 1.65) for controls (p=0.068). Biological complications were reported in 98 patients (62 cases and 36 controls, p=0.004), most of which were peri-implant disorders (n=86). Conclusions: No evidence that the occurrence of mechanical complications have impact on implant´s survival was obtained. Even though results suggest that it has no influence on the marginal bone level, further research is needed. Biological complications, namely peri-implant pathology, have greater incidence in patients with mechanical complications.
Background: Despite the high success rates, dental implants are not free from complications. The occurrence of mechanical complication can be a source of frustration not only for the patient but also for the clinician. The relationship between the presence of these complications and clinical outcomes is unclear. Objective: The aim of this study was to investigate the impact of mechanical complications on the outcome measures for implant success: survival, marginal bone resorption and incidence of complications Materials and methods: This case control study included a total of 564 patients, divided into two groups: 282 patients identified with mechanical complications occurring in the fixed prosthetic rehabilitations supported by immediate function implants, and a control group. Pairing was done for gender, age (within a range of 3 years) and months of follow-up. Primary outcome measures were implant survival, evaluated based on function of the implant as part of a prosthetic rehabilitation unit; secondary outcome measures were marginal bone level and biological complication parameters (peri-implant pathology, soft tissue inflammation, fistula formation, abscess formation). Results: The average follow-up was 90 months. The success rate was 100% and 99.6% for cases and controls, respectively (p=0.317). The average marginal bone loss was 1.72 (95% CI: 1.60; 1.84) for cases and 1.55 (95% CI: 1.45; 1.65) for controls (p=0.068). Biological complications were reported in 98 patients (62 cases and 36 controls, p=0.004), most of which were peri-implant disorders (n=86). Conclusions: No evidence that the occurrence of mechanical complications have impact on implant´s survival was obtained. Even though results suggest that it has no influence on the marginal bone level, further research is needed. Biological complications, namely peri-implant pathology, have greater incidence in patients with mechanical complications.
Description
Tese de mestrado, Epidemiologia, Universidade de Lisboa, Faculdade de Medicina, 2020
Keywords
Implantes dentários Complicações mecânicas Sobrevivência do implante Perda óssea Complicações biológicas Teses de mestrado - 2020