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Análise da sobrevivência e complicações dos implantes zigomáticos em um período de 6-14 anos de acompanhamento

AUTORES

Eduardo Jose de Moraes
Especialista em CTBMF – Unigranrio; Mestre em Implantodontia – UCCB; Diretor científico – IDM-RJ.
Orcid: 0000-0002-6662-2561.

Daniel Farias
Especialista em Implantodontia – Universidade do Chile, Chile.

Sergio Adrian Olate
Especialista, mestre e doutor em CTBMF – Unicamp; Professor titular – UniFrontera, Chile.
Orcid: 0000-0001-8153-0676.

Luis Eduardo Benevides de Moraes
Especialista em CTBMF – OCM/HNMD Marinha do Brasil; Especialista em Implantodontia – Unifeso. Staff – IDM-RJ.
Orcid: 0000-0001-9630-7255.


RESUMO

Objetivo: o presente estudo consiste em uma análise retrospectiva da sobrevida e complicações em um estudo clínico de pacientes reabilitados com implantes zigomáticos instalados em maxilares atróficos. Material e métodos: pacientes de três centros clínicos de autores no Brasil (IDM Clinic, Rio de Janeiro) e no Chile (Universidad de Los Andes, Santiago; e Universidad de La Frontera, Temuco), com atrofia maxilar severa, reabilitados com prótese fixa total maxilar com implantes zigomáticos e implantes convencionais submetidos à carga imediata. Os pacientes foram convocados para acompanhamento clínico e radiográfico anualmente após a instalação da prótese, para avaliação da estabilidade dos implantes, condições da prótese e tecidos peri-implantares. Resultados: foram colocados 16 implantes convencionais, quatro implantes longos (21 mm) e 56 implantes zigomáticos. Em todos os casos, a membrana sinusal estava perfurada nos três pacientes que apresentavam patologias do seio maxilar. Nestes casos, uma pequena janela foi feita na parede anterior para promover a curetagem e limpeza dos seios da face. Não houve falhas e fenestração de mucosa com exposição de roscas dos implantes zigomáticos instalados. Conclusão: os implantes zigomáticos instalados com o protocolo de carga imediata apresentaram um elevado índice de sucesso. As principais complicações observadas foram complicações mecânicas, inflamação da mucosa peri-implantar e sinusite, com incidência de 27%, 18% e 13%, respectivamente.

Palavras-chave – Implantes zigomáticos; Complicações; Maxila atrófica.


ABSTRACT

Objective: the present study consists in a retrospective analysis of survival and complications in a clinical study of patients rehabilitated with zygomatic implants installed in atrophic jaws. Material and methods: patients from three clinical centers of authors clinics in Brazil (IDM Clinic, Rio de Janeiro) and Chile (Universidad de Los Andes, Santiago; and Universidad de La Frontera, Temuco) with severe maxillary atrophy rehabilitated by maxillary full fixed prosthesis with zygomatic implants and conventional implants submitted to immediate load. The patients were recalled for clinical and radiographic follow-up annually aft er prosthesis installation, to evaluation of implants stability, prostheses conditions and perimplant tissues. Results: a total of 16 conventional implants, 4 long implants (21 mm) and 56 zygomatic implants were placed. In all cases, the sinus membrane was perforated in the 3 patients that presented pathologies of the maxillary sinus. In these cases a small window was made in the anterior wall to promote the curettage and sinus cleaning. None of the conventional implants failed and none of the zygomatic implants failed or presented mucosa fenestration. Conclusion: the zygomatic implants placed according to an immediate loading protocol, presented a statistically important higher survival. The main complications observed, were mechanical, perimplant soft tissue inflamation and sinusitis, with an incidence of 27%, 18% and 13% respectively.

Key words – Zygomatic implants; Complications; Atrophic maxilla.


Recebido em jan/2022
Aprovado em jan/2022

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