Implante imediato associado à infecção periapical crônica: relato de caso clinico
DOI:
https://doi.org/10.21270/archi.v7i5.2994Resumo
A busca por novas técnicas cirúrgicas preservando a integridade dos tecidos periodontais associado à reabilitação com implantes dentários favorece a qualidade estética e funcional, garantindo assim a satisfação dos pacientes. O objetivo do trabalho foi demonstrar a reabilitação com implante imediato em alvéolo com infecção associado a provisionalização imediata e proservação de 36 meses após a reabilitação final. Paciente apresentou-se com elemento 24 com mobilidade grau III, defeitos ósseos ao redor do dente, drenagem purulenta e bolsa profunda à sondagem de (>7 mm). Foi utilizado o protocolo de regeneração óssea guiada (ROG) com o substituto ósseo para preenchimento do “gap” entre o implante e o osso alveolar, com o uso de tela de titânio para ganho ósseo vertical e horizontal e membranas autólogas de fibrina obtidas através do processo de centrifugação e preparo. Após o período de osseointegração, foram realizados procedimentos de moldagem personalizada para a reabilitação final com prótese metalocerâmica. No período de 36 meses de acompanhamento clínico e radiográfico não há sintomatologia dolorosa, infecção, mobilidade do implante e perda óssea peri-implantar acentuada. O paciente apresentou-se satisfeito com relação à estética e função protética.Descritores: Infecção; Implantes Dentários; Reabilitação Oral.
Downloads
Referências
Buser D, Weber HP, Brägger U, Balsiger C. Tissue integration of one-stage implants: three-year results of a prospective longitudinal study with hollow cylinder and hollow screw implants. Quintessence Int. 1994; 25(10):679-86.
Ortega-Martinez J, Perez-Pascual T, Mareque-Bueno S, Hernández-Alfaro F, Férres-Padró E. Immediate implants following tooth extraction. A systematic review. Med Oral Patol Oral Cir Bucal. 2012;17(2):e251-61.
Velasco Ortega E, Jimenez Guerra JA, Monsalve Guil L, Ortiz Garcia I, España López E, Matos Garrido N. Carga inmediata de implantes insertados en alvéolos postextracción. Resultados clínicos a dos años. Avances en Periodoncia. 2015;27(1):37-45.
Müller A, Silva ACBR, Schmidt LTH. Implante unitário submetido à carga imediata. RGO. 2004; 52(1):27-41.
Sabir M, Alam MN. Survival of implants in immediate extraction sockets of anterior teeth: Early clinical results. J Clin Diagn Res. 2015; 9(6):ZC58-61.
Balaguer-Marti JC, Peñarrocha-Oltra D, Balaguer-Martinez J, ocha-PeñarDiago M. Immediate bleeding complications in dental implants: A systematic review. Med Oral Patol Oral Cir Bucal. 2015; 20(2):e231-8.
Paolantonio M, Dolci M, Scarano A, D’archivio D, di Placido G, Tumini V et al. Immediate implantation in fresh extraction sockets. A controlled clinical and histologic study in man. J Periodontol. 2001; 72(11):1560-71.
Bell CL, Diehl D, Bell BM, Bell RE. The immediate placement of dental implants into extraction sites with periapical lesions: A retrospective chart review. J Oral Maxillofac Surg. 2011; 69(6):1623-7.
Casap N, Zeltser C, Wexler A, Tarazi E, Zeltser R. Immediate placement of dental implants into debrided infected dentoalveolar sockets. J Oral Maxillofac Surg. 2007; 65(3):384-92.
Crespi R, Capparè P, Gherlone E. Fresh socket implants in periapical infected sites in humans. J Periodontol. 2010; 81(3):378-83.
Crespi R, Capparé P, Gherlone E. Immediate loading of dental implants placed in periodontally infected and non-infected sites: A 4-year follow-up clinical study. J Periodontol. 2010; 81(8):1140-6.
Del Fabbro M, Boggian C, Taschieri S. Immediate implant placement into fresh extraction sites with chronic periapical pathologic features combined with plasma rich in growth factors: Preliminary results of single-cohort study. J Oral Maxillofac Surg. 2009; 67(11):2476-84.
Deng F, Zhang H, Zhang H, Shao H, He Q, Zhang P. A comparison of clinical outcomes for implants placed in fresh extraction sockets versus healed sites in periodontally compromised patients: A 1-year follow-up report. Int J Oral Maxillofac Implants. 2010; 25(5):1036-40.
Fugazzotto P. A retrospective analysis of immediately placed implants in 418 sites exhibiting periapical pathology: Results and clinical considerations. Int J Oral MaxIllorofac Implants. 2012; 27(1):194-202.
Jung RE, Zaugg B, Philipp AO, Truninger TC, Siegenthaler DW, Hämmerle CH. A prospective, controlled clinical trial evaluating the clinical radiological and aesthetic outcome after 5 years of immediately placed implants in sockets exhibiting periapical pathology. Clin Oral Implants Res. 2013; 24(8):839-46.
Khademi A, Shadmehr E, Ajami M, Rismanchian M, Razav SM. Histologic and histomorphometric assessment of implants and periapical tissues when placed in the sockets of extracted teeth, teeth with periapical lesions, and healed lesions: A canine study. J Oral Implantol. 2013;39(6):709-13.
Lindeboom JA, Tjiook Y, Kroon FH. Immediate placement of implants in periapical infected sites: A prospective randomized study in 50 patients. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2006;101(6):705-10.
Marconcini S, Barone A, Gelpi F, Briguglio F, Covani U. Immediate implant placement in infected sites: A case series. J Periodontol. 2013; 84(2):196-202.
Naves MM, Horbylon BZ, Gomes CF, Menezes HHM, Bataglion C, Magalhães D. Immediate implants placed into infected sockets: A case report with 3-year follow-up. Braz Dent J. 2009; 20(3):254-8.
Siegenthaler DW, Jung RE, Holderegger C, Roos M, Hämmerle CHF. Replacement of teeth exhibiting periapical pathology by immediate implants. A prospective, controlled clinical trial. Clin Oral Impl Res. 2007; 18(6):727-37.
Truninger TC, Philipp AO, Siegenthaler DW, Roos M, Hämmerle CH, Jung RE. A prospective, controlled clinical trial evaluating the clinical and radiological outcome after 3 years of immediately placed implants in sockets exhibiting periapical pathology. Clin Oral Implants Res. 2011; 22(1):20-7.
Villa R, Rangert B. Early Loading of Interforaminal Implants Immediately Installed after Extraction of Teeth Presenting Endodontic and Periodontal Lesions. Clinic Implant Dent Relat Res. 2005; 7(Suppl 1):S28-35.
dos Santos PL, de Molon RS, Queiroz TP, Okamoto R, de Souza Faloni AP, Gulinelli JL et al. Evaluation of bone substitutes for treatment of peri-implant bone defects: biomechanical, histological, and immunohistochemical analyses in the rabbit tíbia. J Periodontal Implant Sci. 2016; 46(3):176-96.
Grandi T, Garuti G, Samarani R, Guazzi P, Forabosco A. Immediate loading of single pos-extractive implants in the anterior maxila. J Oral Implantol. 2012; 38(1):477-84.
Shetye O, Shetye NK, Louis A, Roy I. Immediate implantation in an extraction socket: A review. Int J Contemp Dent Med Rev. 2015; Article ID 160115.
Agustín-Panadero R, Serra-Pastor B, Chust-Lopez C, Fons-Font A, Ferreiroa A. Immediate placement of single implant simultaneously with immediate loading in a fresh socket associated to periapical infection: A clinical case report. J Clin Exp Dent. 2015; 7(1):e175-9.
Peredo-Paz LG, Francischone CE, Ferreira E, Sidney R. Carga imediata em próteses unitárias pós exodontia, em áreas estéticas. 2008; 2:92-109. Rev Dental Press Periodontia Implantol. 2008; 2(1):92-109.
Zani SR, Alves RA, Korb SHB, Rivaldo EG, Frasca LCF. Colocação de implante imediato após exodontia: Relato de caso clínico. Odontol Clín-Cient. 2011; 10(3):281-4.
Albrektsson T, Brånemark PI, Hansson HA, Lindström J. Osseointegrated titanium implants. Requirements for ensuring a long-lasting, direct bone-to-implant anchorage in man. Acta Orthop Scand. 1981; 52(2):155-70.
Wilson TG Jr. Guided tissue regeneration around dental implants in immediate and recent extraction sockets: Initial observations. Int J Periodontics Restorative Dent. 1992; 12(3):185-93.
Garber DA, Salama MA, Salama H. Immediate total tooth replacement. Compend Contin Educ Dent. 2001; 22(3):210-8.
Tabrizi R, Azizi M. Mesiodistal bone loss of fresh socket placed implants and delay placed implants at the anterior of the maxila. Int J Oral Implantol Clin Res. 2013; 4(2):63-7.
Waasdorp JA, Evian CI, Mandacchia M. Immediate placement of implants into infected sites: A systematic review of the literature. J Periodontol. 2010; 81(6):801-8
Álvarez-Camino JC, Valmaseda-Castellón E, Gay-Escoda C. Immediate implants in fresh sockets associated to periapical infections processos- A systematic review. Med Oral Patol Oral Cir Bucal. 2013; 18(5):e780-5
Lee JW, Kim SG, Kim JY, Lee JC, Choi JY, Dragos R, et al. Restoration of a peri-implant defect by platelet-rich fibrin. Oral Surg Oral Med Oral Pathol Oral Radiol. 2012;113:459-63.
Boora P, Rathee M, Bhoria M. Effect of platelet rich fibrin (PRF) on peri-implant soft tissue and crestal bone in one-stage implant placement: a randomized controlled trial. J Clin Diagn Res. 2015; 9(4):ZC18-21.