Exitos y fracasos en carga inmediata posterior comparando implantes cortos y anchos v/s implantes estandares
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Fecha
2012
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Facultad/escuela
Idioma
es
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Universidad Andrés Bello
Nombre de Curso
Licencia CC
Licencia CC
Resumen
La Odontología avanza de tal forma que para un clínico es difícil mantener una completa actualización de sus conocimientos. La gran cantidad de estudios en biología, los nuevos materiales y las técnicas procedentes de este avance, no nos dejan mucho tiempo disponible para introducir nuevas técnicas en nuestra clínica. En otras palabras, el tiempo que se emplea para incorporar una técnica puede ser suficiente para que ella experimente modificaciones o incluso quede en desuso. Este mismo fenómeno se produjo con la osteointegracíón, principalmente en lo referente al tiempo de aplicación de la carga sobre los implantes.
Cuando Branemark introdujo el concepto de Oseointegración en 1969 se estableció un protocolo de carga para los implantes, que debía realizarse tras 6 meses en el maxilar y 4 en la mandíbula para lograr una adecuada cicatrización ósea y remodelación de la interfase hueso-implante, sin interposición de tejido fibroso. El hecho de adoptar estos protocolos en la implantología clínica supone tasas de éxito muy elevadas, por encima del 95%, con una predictibilidad casi exacta en la evolución del caso. Sin embargo, la creciente exigencia de los profesionales y sobre todo de los pacientes, hace que estos largos tiempos de espera hayan ido disminuyendo. Por este motivo, la carga inmediata supone una importante línea de investigación en la implantología moderna; cada vez hay una mayor cantidad de publicaciones científicas referentes a esta materia, que permiten resolver un creciente número de casos de manera predecible reduciendo de forma significativa los tiempos de espera entre la fase quirúrgica y protésica, consiguiendo nuestra satisfacción y sobre todo la del paciente.
lntroduction: immediate loading is the fact of subjecting biophysical functional masticatory loads; one or more implants in the first 24 hours after implantation, thereby synthesizing the surgical and prosthetic phases in a single work session. Objective: The objective of this study is to assess whether there is any significant difference in the success of osseointegration between implants immediately loaded short and long in the posterior. Materials and Methods: This study was conducted with patients from the Chilean Center for Osseointegration, which was evaluated on clinical and radiographic parameters to determine the successful osseointegration of implants subjected to immediate loading. Results: There were 334 implants installed in the posterior, both in the maxilla and the mandible of 180 patients (106 female and 74 male), installed under the Branemark protocol. In all cases, immediate loading was performed with temporary crowns within 24 hrs postsurgery. Of the 334 implants subjected to immediate loading 251 were installed in the upper jaw and 83 in the jaw, of which 6 (2.40%) in the maxilla and 4 (4.80%) in the jaw, failed. 8.6% of 58 short implants and 1.8% of 276 long implants failed, thus observed a statistically significant because despite being smaller the sample size in short implants, is where he found a higher failure rate compared to longer implants installed. Of 157 implants in extraction site 3 (1.9%) implants failed, while of 177 healthy lip implants installed in the failure was 7 (4.0%) implants, no statistically significant differences. Conclusions: Dental implants subjected to immediate loading in the rear area can be installed without significant differences in the maxilla and the mandible, which implies a lower risk of failure. The clinical procedure of immediate loading in the posterior with short implants demonstrated a statistically significant when compared with longer implants, which means a higher risk of failure. However, the high success rate makes this a viable alternative, as long as they perform well spent surgical protocol, a modified implant design, obtaining primary stability and adequate prosthetic criteria for immediate loading. lmmediate postextraction implantation is to be nowadays a reliable alternative for implant osseointegration.
lntroduction: immediate loading is the fact of subjecting biophysical functional masticatory loads; one or more implants in the first 24 hours after implantation, thereby synthesizing the surgical and prosthetic phases in a single work session. Objective: The objective of this study is to assess whether there is any significant difference in the success of osseointegration between implants immediately loaded short and long in the posterior. Materials and Methods: This study was conducted with patients from the Chilean Center for Osseointegration, which was evaluated on clinical and radiographic parameters to determine the successful osseointegration of implants subjected to immediate loading. Results: There were 334 implants installed in the posterior, both in the maxilla and the mandible of 180 patients (106 female and 74 male), installed under the Branemark protocol. In all cases, immediate loading was performed with temporary crowns within 24 hrs postsurgery. Of the 334 implants subjected to immediate loading 251 were installed in the upper jaw and 83 in the jaw, of which 6 (2.40%) in the maxilla and 4 (4.80%) in the jaw, failed. 8.6% of 58 short implants and 1.8% of 276 long implants failed, thus observed a statistically significant because despite being smaller the sample size in short implants, is where he found a higher failure rate compared to longer implants installed. Of 157 implants in extraction site 3 (1.9%) implants failed, while of 177 healthy lip implants installed in the failure was 7 (4.0%) implants, no statistically significant differences. Conclusions: Dental implants subjected to immediate loading in the rear area can be installed without significant differences in the maxilla and the mandible, which implies a lower risk of failure. The clinical procedure of immediate loading in the posterior with short implants demonstrated a statistically significant when compared with longer implants, which means a higher risk of failure. However, the high success rate makes this a viable alternative, as long as they perform well spent surgical protocol, a modified implant design, obtaining primary stability and adequate prosthetic criteria for immediate loading. lmmediate postextraction implantation is to be nowadays a reliable alternative for implant osseointegration.
Notas
Tesis (Magíster en Odontología, Especialización en Rehabilitación Oral)
Palabras clave
Rehabilitación Oral, Implantes Dentarios, Chile