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Prótese implanto-suportada: cimentada vs. aparafusada
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Resumo(s)
Introdução: A reabilitação implanto-suportada é uma opção de tratamento comum na prática da Medicina Dentária contemporânea, exibindo elevadas taxas de sobrevivência e sucesso. A expetativa em obter um tratamento final bem-sucedido tem aumentado e surgiram questões relativas às escolhas do clínico. Uma das quais remete-se ao método de retenção da restauração, podendo ser cimentada, aparafusada ou uma combinação de ambos. A literatura sobre o tema é vasta, deixando o Médico Dentista por vezes com informação conflituosa. Objetivo: Analisar dois tipos de retenção de uma restauração implanto-suportada, comparando-os quanto às suas vantagens e desvantagens. Materiais e métodos: Realizou-se uma pesquisa bibliográfica nas bases de dados MEDLINE-Pubmed e Cochrane Collaboration, com as palavras e conetores boleanos “(cement OR screw) AND implant”, “cement-retained” e “screw-retained”. Aplicaram-se limites e, após a avaliação da relevância dos artigos para o tema através da leitura do seu resumo, selecionaram-se 34 artigos. Realizou-se também uma pesquisa manual na Biblioteca da Faculdade de Medicina Dentária, tendo sido selecionados 2 capítulos de livros. Discussão: Diversos fatores influenciam o sucesso a longo prazo das reabilitações consoante o método de retenção utilizado. Estes incluem: a estética, a oclusão, a reversibilidade, a passividade, a selagem marginal, as complicações, a posição e a localização do implante, o custo e o tempo de trabalho. Conclusão: Nenhum dos tipos de retenção demonstrou ser claramente vantajoso em relação ao outro, o que se deve ao facto de ambos os sistemas terem as suas vantagens e desvantagens, tendo por isto, indicações distintas. Contudo, a literatura existente que avalia consoante os vários tipos de reabilitação é escassa. É necessário que se realizem mais ensaios clínicos controlados e randomizados, com amostras maiores que assegurem uma forte evidência científica.
Introduction: Nowadays, implant-supported rehabilitation is a common treatment option in the daily practice of Dentistry, exhibiting high survival and success rates. The expectation to achieve a successful final treatment has increased and questions arise concerning clinical choices. One of those refers to the method of retention of restoration, which can be cemented, screwed or a combination of both. Literature on the subject is vast, leaving the clinician sometimes with conflicting information. Purpose: To assess the two methods of retention of an implant-supported restoration, discussing their advantages and disadvantages. Materials and methods: A MEDLINE-PubMed and Cochrane Collaboration database search was conducted with the free text words and boolean connectors “(cement OR screw) AND implant”, “cement-retained” and “screw-retained”. Filters were applied and assessment of the abstracts of the identified studies was performed. 34 articles were selected. Manual searching in the Library of the Faculdade de Medicina Dentária was also conducted and has been selected two books. Discussion: Several factors influence the long-term success of rehabilitation depending on the method of retention used. These include: aesthetics, occlusion, reversibility, passivity, marginal sealing, complications, position and location of the implant, cost and working time. Conclusion: Neither of the types of retention proved to be clearly advantageous over the other. Both of the systems have their advantages and disadvantages and, for this reason, different indications. However, the available literature including the assessment depending on the various types of rehabilitation is rare. It is necessary to conduct more randomized controlled trials, with larger sample sizes to ensure a strong scientific evidence.
Introduction: Nowadays, implant-supported rehabilitation is a common treatment option in the daily practice of Dentistry, exhibiting high survival and success rates. The expectation to achieve a successful final treatment has increased and questions arise concerning clinical choices. One of those refers to the method of retention of restoration, which can be cemented, screwed or a combination of both. Literature on the subject is vast, leaving the clinician sometimes with conflicting information. Purpose: To assess the two methods of retention of an implant-supported restoration, discussing their advantages and disadvantages. Materials and methods: A MEDLINE-PubMed and Cochrane Collaboration database search was conducted with the free text words and boolean connectors “(cement OR screw) AND implant”, “cement-retained” and “screw-retained”. Filters were applied and assessment of the abstracts of the identified studies was performed. 34 articles were selected. Manual searching in the Library of the Faculdade de Medicina Dentária was also conducted and has been selected two books. Discussion: Several factors influence the long-term success of rehabilitation depending on the method of retention used. These include: aesthetics, occlusion, reversibility, passivity, marginal sealing, complications, position and location of the implant, cost and working time. Conclusion: Neither of the types of retention proved to be clearly advantageous over the other. Both of the systems have their advantages and disadvantages and, for this reason, different indications. However, the available literature including the assessment depending on the various types of rehabilitation is rare. It is necessary to conduct more randomized controlled trials, with larger sample sizes to ensure a strong scientific evidence.
Descrição
Tese de mestrado, Medicina Dentária, Universidade de Lisboa, Faculdade de Medicina Dentária, 2014
Palavras-chave
Implantes dentários Teses de mestrado - 2014