Implantes dentários extralongos extrasinusais em osso zigomático utilizando perfuração ultrassônica: série de casos com 46 implantes e 18 pacientes com 24 meses de acompanhamento

RESUMO

Objetivo: executar e avaliar a técnica utilizando a terapia de implantes dentários zigomáticos com perfuração do corpo do osso zigomático feita com pontas diamantadas ultrassônicas. Material e métodos: 18 pacientes desdentados superiores foram selecionados e receberam pelo menos um implante zigomático instalado com a técnica extrasinusal e utilizando a perfuração ultrassônica, conforme o planejamento virtual para completa solução dos casos. As avaliações dos resultados primários foram baseadas nas taxas de sobrevida do implante e complicações pós-operatórias. Resultados: foram inseridos 46 implantes zigomáticos. As próteses totais sobre implantes foram entregues em até 72 horas após as cirurgias. O acompanhamento máximo após a cirurgia foi de 18 meses (3-24 meses). O tempo operatório foi maior utilizando a cirurgia óssea piezoelétrica, no entanto as cirurgias foram mais confortáveis com o uso de instrumentos ultrassônicos, do ponto de vista do cirurgião operador. A sobrevida do implante foi de 100%, não sendo observadas complicações pós-operatórias nestes 18 pacientes. Conclusão: a cirurgia óssea piezoelétrica se mostrou uma alternativa viável à perfuração tradicional para cirurgia de implante zigomático feita com broca helicoidal. A técnica mostrou sua aplicabilidade, resultando em menos morbidade e maior previsibilidade clínica.

Palavras-chave – Implantes dentários; Maxila atrófica; Zigomático; Enxertos ósseos; Ultrassom cirúrgico.

ABSTRACT

Objective: to manage and evaluate a technique using zygomatic dental implants by perforating the zygoma body using ultrasound diamond tips. Material and methods: 18 completely edentulous patients were selected and received at least 1 zygomatic implant installed under the extra-sinus technique and by ultrasound instrumentation, according to the computerized virtual planning. The primary outcomes were evaluated according to the survival rates and post-operative complications. Results: overall, 46 zygoma implants were inserted. All implant-supported, complete, fixed prostheses were delivered up to 72 hours after surgeries. The maximum follow-up time was 18 months (3-18 months). The operative time was greater for piezoelectric instrumentation; however, all surgeries were perceived more comfortable in this way according to the operator. Dental implant survival was 100%, and no complications were observed for these 18 patients. Conclusion: bone piezo surgery is a viable alternative to traditional osteotomy for zygoma dental implants using helicoidal burs. The applicability of this technique was demonstrated resulting in less morbidity are more clinical predictability.

Key words – Dental implants; Atrophic maxilla; Zygomatic bone; Bone grafts; Surgical ultrasound.

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