Tratamento da peri-implantite combinando estratégias cirúrgicas e não cirúrgicas: 18 meses de acompanhamento

RESUMO

O objetivo deste relato de caso clínico foi ilustrar uma proposta de tratamento de peri-implantite. Paciente do sexo feminino, com 71 anos de idade, saudável, não fumante, procurou a clínica com queixa de dor e sangramento na região do implante que estava em função há três anos. Após exame clínico e radiográfico, verificou-se que o implante na região do dente 44 apresentava sinais clínicos e radiográficos característicos de peri-implantite. Foi realizado tratamento não cirúrgico, com orientação de higiene oral, desorganização do biofilme e, posteriormente, o tratamento cirúrgico com debridamento mecânico da superfície do implante, descontaminação local com tetraciclina e colocação de enxerto ósseo xenógeno associado ao enxerto de tecido conjuntivo subepitelial. Após um mês, constatou-se a eliminação do processo inflamatório e o restabelecimento da morfologia dos tecidos peri-implantares, mantendo-se desta forma durante os 18 meses de acompanhamento. É válido ressaltar que o estabelecimento de terapia periodontal de suporte rigorosa foi primordial para o sucesso a longo prazo.

Palavras-chave – Implantes dentários; Peri-implantite; Mucosite.

ABSTRACT

The objective of this clinical case report is to illustrate a proposed treatment for peri-implantitis. A female, 71 years-old, healthy, and non-smoker patient, came to the clinic complaining of pain and bleeding in the region of the implant that had been in use for 3 years. After clinical and radiographic examination, it was found that the implant in the region of tooth 44 presented clinical and radiographic signs characteristic of peri-implantitis. Non-surgical treatment was carried out, with guidance on oral hygiene, disorganization of the biofilm and subsequently, surgical treatment with mechanical debridement of the implant surface, local decontamination with tetracycline and placement of a xenogeneic bone graft associated with the subepithelial connective tissue graft. After 1 month, the inflammatory process was eliminated and the morphology of the peri-implant tissues was restored, remaining this way for 18 months of follow-up. It is worth noting that the establishment of rigorous supportive periodontal therapy was paramount to long-term success.

Key words – Dental implants; Peri-implantitis; Mucositis.

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