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Complicações em reabilitações individuais sobre implantes dentários: uma revisão sistemática
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Introdução: A reabilitação de peças dentárias únicas tem vindo a tornar-se uma prática clínica habitual. O tratamento de escolha nestas situações é a reabilitação fixa implanto-suportada. O sucesso associado a este procedimento avalia não apenas resultados clínicos como a sobrevivência dos implantes, das coroas e satisfação dos pacientes, mas também a ocorrência de complicações técnicas, estéticas e biológicas. Objetivo: Pretende-se responder à questão PICO: “Na reabilitação de zonas edêntulas com coroas unitárias implanto-suportadas, qual a prevalência de complicações técnicas, biológicas e estéticas, e qual a frequência com que ocorrem relacionadas com o tipo de implantes, pilares, localização na arcada, tipo de retenção e material protético?”. Materiais e Métodos: Foi efetuada uma pesquisa nas bases de dados secundária (Cochrane) e primária (MEDLINE) com as palavras-chave dental implant e complications para estudos em humanos, sem restrições temporais, nas línguas portuguesa, espanhola e inglesa. Os dados foram analisados através de meta-regressões (STATA/SE 12.0) com um intervalo de confiança de 95%. Resultados: Foram incluídos 36 estudos (2940 implantes e 2879 coroas). A taxa de sobrevivência média das coroas unitárias foi de 95,7%, enquanto que dos implantes foi igual a 96,9%. Foram verificadas 661 complicações (437 por razões técnicas, 162 biológicas e 62 estéticas), o que resulta numa taxa de complicações total de 22,1%, taxa de complicações técnicas de 14,8%, biológicas de 5,7% e estéticas de 5,4%. Conclusões: O diâmetro dos implantes, a sua localização, o tipo de material das dos pilares e o tipo de retenção das coroas têm uma relação estatisticamente significativa com o número de complicações, assim como em relação à taxa de sobrevivência das coroas. Conclui-se, contudo, que são necessários mais estudos relativos ao tema sobre o qual incidiu esta revisão sistemática.
Introduction: Single-tooth rehabilitation has become an usual practice. In these cases, oral implants are the predominant treatment modality. Current paradigms for treatment success in implant dentistry are based not only on clinical outcomes such as implant survival, crown survival and patient satisfaction, but also on rates of technical, esthetic and biological complications. Purpose: The aim was to answer the PICO question: “Concerning the rehabilitation of edentulous spaces with implant-supported single crowns, what is the prevalence of technical, biological and esthetic complications, and in which frequency do they occur associated with implant and abutment types, intraoral location, type of retention and prosthetic material?”. Materials and Methods: Scientific search was performed in a secondary database (Cochrane) and a primary database (MEDLINE) using the keywords dental implant and complications for studies in humans, without time restrictions, written in Portuguese, Spanish or English. Data were analyzed through meta-regressions (STATA/SE 12.0) with a 95% confidence interval. Results: Thirty-six studies were included (2940 implants and 2879 crowns). The survival rate for single crowns was 95,7% and for the implants 96,9%. 661 complications were noticed (437 for technical reasons, 162 caused by biological factors and 62 were related to esthetics). The overall complication rate was 22,1%; technical complications occurred with a rate of 14,8%, biological complications happened with a rate of 5,7% and esthetic complications with a rate of 5,4%. Conclusions: Statistically significance results were observed, specially concerning the influence of the implants diameter, its localization, abutments and crowns’ material and type of crown/abutment retention in the number of technical, esthetic and total number of complications, and also on the survival rate of the crowns. Nevertheless, more studies related to this subject are needed.
Introduction: Single-tooth rehabilitation has become an usual practice. In these cases, oral implants are the predominant treatment modality. Current paradigms for treatment success in implant dentistry are based not only on clinical outcomes such as implant survival, crown survival and patient satisfaction, but also on rates of technical, esthetic and biological complications. Purpose: The aim was to answer the PICO question: “Concerning the rehabilitation of edentulous spaces with implant-supported single crowns, what is the prevalence of technical, biological and esthetic complications, and in which frequency do they occur associated with implant and abutment types, intraoral location, type of retention and prosthetic material?”. Materials and Methods: Scientific search was performed in a secondary database (Cochrane) and a primary database (MEDLINE) using the keywords dental implant and complications for studies in humans, without time restrictions, written in Portuguese, Spanish or English. Data were analyzed through meta-regressions (STATA/SE 12.0) with a 95% confidence interval. Results: Thirty-six studies were included (2940 implants and 2879 crowns). The survival rate for single crowns was 95,7% and for the implants 96,9%. 661 complications were noticed (437 for technical reasons, 162 caused by biological factors and 62 were related to esthetics). The overall complication rate was 22,1%; technical complications occurred with a rate of 14,8%, biological complications happened with a rate of 5,7% and esthetic complications with a rate of 5,4%. Conclusions: Statistically significance results were observed, specially concerning the influence of the implants diameter, its localization, abutments and crowns’ material and type of crown/abutment retention in the number of technical, esthetic and total number of complications, and also on the survival rate of the crowns. Nevertheless, more studies related to this subject are needed.
Descrição
Tese de mestrado, Medicina Dentária, Universidade de Lisboa, Faculdade de Medicina Dentária, 2015
Palavras-chave
Implantes dentários Complicações Teses de mestrado - 2015