Implante imediato com guia e provisório prototipados: relato de caso em área estética

Amanda Piol Cardoso
Departamento de Implantodontia do INSOE, Vila Velha – ES

 Gabriel Villas Bôas Casotti Simão
Departamento de Implantodontia do INSOE, Vila Velha – ES

 Jefferson Trabach Pires
Departamento de Implantodontia do INSOE, Vila Velha – ES; Departamento de Implantodontia e Reabilitação Oral da SOEP, Porto Velho – RO

 Bruno Costa Martins de Sá
Departamento de Implantodontia do INSOE, Vila Velha – ES; Departamento de Implantodontia e Reabilitação Oral da SOEP, Porto Velho – RO 

Celson Domingo de Calais
Departamento de Implantodontia do INSOE, Vila Velha – ES

 André Javarini
Departamento de Implantodontia do INSOE, Vila Velha – ES

 Tárcio Hiroshi Ishimine Skiba
Departamento de Implantodontia do INSOE, Vila Velha – ES; Departamento de Implantodontia e Reabilitação Oral da SOEP, Porto Velho – RO
ORCID: 0000-0003-3335-7279

 

DOI: https://doi.org/10.71440/2675-5610.10.4.25.524-528.art  

 

RESUMO

A reabilitação em áreas anteriores com alta demanda estética exige um planejamento criterioso e técnicas que favoreçam a previsibilidade clínica. Com o avanço da odontologia digital, procedimentos como a cirurgia guiada tem viabilizado abordagens menos invasivas, com excelente controle das etapas cirúrgicas e protéticas. Neste artigo, relatamos um caso clinico de reabilitação do elemento 11 com implante imediato, utilizando guia cirúrgico prototipado (impresso em 3D) e provisório prototipado (PMMA fresado). O paciente apresentava fistula e lesão periapical no terço médio da raiz, o que levou a indicação de extração minimamente traumática seguida da instalação imediata do implante. Optou-se pela abordagem flapless, complementada com enxerto de tecido conjuntivo subepitelial (ETCS) e preenchimento do gap com substituto ósseo. O provisório fresado em PMMA foi instalado na mesma sessão. A integração entre o planejamento digital e a execução clinica permitiu alcançar um posicionamento tridimensional ideal do implante, além de preservar os tecidos peri-implantares e proporcionar um resultado estético previsível. O caso reforça a importância do fluxo digital associado a técnica cirúrgica bem indicada para alcançar excelência nos tratamentos implantossuportados em zona estética.

 Palavras-chave: Implantes Dentarios; Enxerto Ósseo; Tecido Conjuntivo.

 

Immediate implant with guided surgery and prototyped provisional crown: a case report in the esthetic zone

ABSTRACT

Oral rehabilitation in anterior areas with high esthetic demands requires careful planning and techniques that favor clinical predictability. With the advancement of digital dentistry, procedures such as guided surgery have enabled less invasive approaches, with excellent control of the surgical and prosthetic stages. In this article, we report a clinical case of rehabilitation of tooth 11 with immediate implant placement, using a 3D-printed surgical guide and a prototyped provisional crown. The patient presented with a fistula and a periapical lesion extending to the middle third of the root, which led to indication for minimally traumatic extraction followed by immediate implant placement. A flapless approach was chosen, complemented by subepithelial connective tissue grafting (SCTG) and filling of the gap with a bone substitute. The milled PMMA provisional crown was delivered in the same session. The integration of digital planning and clinical execution allowed for ideal three- dimensional implant positioning, in addition to preserving peri-implant tissues and providing a predictable esthetic result. This case reinforces the importance of a digital workflow associated with a well-indicated surgical technique to achieve excellence in implant-supported treatments in the esthetic zone.

Keywords: Dental Implants; Bone Grafting; Connective Tissue.

 

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