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Influência das técnicas de fresagem convencional, subfresagem, expansão óssea e osseodensificação em osso tipo III e IV na estabilidade inicial e contra-torque: estudo in vitro

RESUMO

Objetivo: avaliar, in vitro, a estabilidade inicial dos implantes instalados em ossos de baixa densidade (tipos III e IV), utilizando as técnicas de fresagem convencional, subfresagem, expansão óssea e osseodensificação. Material e métodos: para este estudo foram confeccionadas cavidades dimensionadas para o diâmetro dos implantes cônicos DSP (Campo Largo, Paraná, Brasil) em blocos de poliuretano em que foram inseridos 10 implantes para cada técnica de fresagem: convencional (CO) subfresagem (SB), expansão óssea (EO) e osseodensificação (OD) e em cada tipo ósseo (III e IV). A estabilidade inicial foi aferida com Osstell e os torques de inserção (TI) e remoção (TR) com auxílio de torquímetro analógico. Os resultados foram tabulados e comparados estatisticamente por meio dos testes Anova 2 fatores e Tukey, a correlação entre o TI, TR e a frequência de ressonância (ISQ) foi averiguada por testes de Person. Resultados: os maiores de TI e TR foi da técnica de expansão óssea em ambos os tipos ósseos, III, IV, (p< 0.05). Para frequência de ressonância, o valor de ISQ foi superior em todas as técnicas quando comparado à fresagem convencional (p< 0.05). O teste de Pearson demostrou correlação muito forte entre TI e TR (p< 0,001, r= 0,877) e forte entre TI e FR (p< 0,001, r= 0,830) e TR e ISQ (p< 0,001, r= 0,803). Conclusão: as técnicas de subfresagem, expansão óssea e osseodensificação apresentaram adequada estabilidade primária em ossos de baixa densidade (tipo III e IV) quando comparado à fresagem convencional.

Palavras-chave – Osseodensificação; Subfresagem; Expansão óssea.


ABSTRACT

Objective: to evaluate, in vitro, the initial stability of implants installed in low-density bone (types III and IV) using conventional drilling, under-drilling, bone expansion and osseodensification techniques. Material and methods: for this study, cavities sized to the diameter of DSP (Campo Largo, Paraná, Brazil) conical implants were made in polyurethane blocks into which 10 implants were inserted for each drilling technique, Conventional (CO) undermilling (SB), bone expansion (EO) and osseodensification (OD), and in each bone type (III and IV). The initial stability was measured with Osstell (RF), and the insertion (IT) and removal (RT) torques with the aid of a torque tester analogue. The results were tabulated and statistically compared using ANOVA 2-way and Tukey tests, and the correlation between the IT, RT, and the resonance frequency (RF) was ascertained by Pearson tests. Results: the highest IT and RT were from the bone expansion technique in both bone types (III, IV) (p < 0.05). For FR, the ISQ value was higher in all techniques when compared to conventional drilling (p < 0.05). Pearson’s test showed a very strong correlation between TI and TR (p < 0.001, r = 0.877) and a strong correlation between TI and FR (p < 0.001, r = 0.830) and TR and FR (p < 0.001, r = 0.803). Conclusion: the under-drilling, bone expansion and osseodensification techniques showed adequate primary stability in low-density bones (type III and IV) when compared to the conventional drilling technique, using insertion torque and resonance frequency as main references.

Key words – Osseodensification; Under-drilling; Bone expansion.

Referências

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