Shirley Oliveira Selvati
Pós-graduanda em Implantodontia – Faculdade São Leopoldo Mandic – Serra/ES
ORCID: 0009-0000-9980-5025

Fabrício Dutra Tebaldi
Mestre e Especialista em Prótese Dentária (Mandic)
ORCID: 0000-0002-6593-5427

Khalila Chequer Cotrim
Doutoranda em Implantodontia (UNG) e Especialista em Implantodontia (Mandic)
ORCID: 0009-0005-0397-7049

Eduardo Cláudio Lopes de Chaves e Mello Dias
Especialista e Mestre em Implantodontia – Unigranrio Doutorado em Implantodontia – Faculdade São Leopoldo Mandic
ORCID: 0000-0002-4541-1095

DOI: https://doi.org/10.71440/2675-5610.10.4.25.516-522.art

RESUMO

O tratamento da região anterior da maxila representa um grande desafio na Implantodontia, especialmente em casos de agenesia, que frequentemente resultam em atrofia do rebordo alveolar. Nesses casos, o planejamento digital torna-se uma ferramenta fundamental, permitindo a integração de exames radiográficos (DICOM) e escaneamentos intraorais (STL) em softwares gratuitos. Essa abordagem possibilita uma análise detalhada da anatomia do paciente, antecipando dificuldades e aumentando a previsibilidade do tratamento. Este trabalho apresenta o tratamento multidisciplinar de um caso de agenesia do incisivo lateral superior direito (elemento 12), no qual uma abordagem multidisciplinar envolvendo Ortodontia, Implantodontia, Periodontia e Prótese Dentária foi de extrema importância para a obtenção de um resultado estético a longo prazo. Foram utilizadas ferramentas digitais avançadas para planejamento, além de abordagens especializadas, como cirurgia guiada estática, regeneração óssea guiada, com a instalação do implante em posicionamento tridimensional ideal. Os tecidos moles peri-implantares foram manipulados pela Técnica do Rolo Modificada, além de cuidadosamente trabalhados com o desenho da prótese provisória a fim de obter um perfil estético adequado dos tecidos moles. Desta forma, foi possível alcançar um resultado estético e funcional ideal, garantindo previsibilidade, segurança e conforto à paciente, conforme demonstrado no acompanhamento clínico de 4 anos.

Palavras-chave: Planejamento virtual; cirurgia guiada estática; implante dentário; agenesia; regeneração óssea guiada.

Treatment of Maxillary Lateral Incisor Agenesis with Guided Surgery and Guided Bone Regeneration in a Young Patient: A 4-Year Clinical Case Report

ABSTRACT

The treatment of the anterior maxillary region represents a significant challenge in Implantology, particularly in cases of agenesis, which often lead to alveolar ridge atrophy. In such cases, digital planning becomes a fundamental tool, enabling the integration of radiographic data (DICOM) and intraoral scans (STL) using free software. This approach allows for a detailed analysis of the patient’s anatomy, anticipating challenges and increasing treatment predictability. This study presents the multidisciplinary management of a case of agenesis of the maxillary right lateral incisor (tooth 12), in which a multidisciplinary approach involving Orthodontics, Implantology, Periodontics, and Prosthodontics was essential to achieve a long-term esthetic outcome. Advanced digital tools were employed for planning, along with specialized approaches such as static guided surgery and guided bone regeneration, ensuring placement of the implant in an optimal three-dimensional position. The peri-implant soft tissues were manipulated using the Modified Roll Technique and carefully shaped with the provisional prosthesis design to achieve an adequate esthetic soft-tissue profile. As a result, an optimal esthetic and functional outcome was achieved, ensuring predictability, safety, and patient comfort, as demonstrated over a 4-year clinical follow-up.

 Keywords: Virtual planning; static guided surgery; dental implants; tooth agenesis; guided bone regeneration.

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