Preservação alveolar de molar com perda óssea severa decorrente de periodontite

Trabalho apresenta a técnica de preservação alveolar com substituto ósseo de hidroxiapatita bovina associado à membrana colágena.

RESUMO

A remodelação do osso alveolar e tecidos moles corresponde a uma resposta fi siológica após extração de um elemento dentário. Essa reabsorção resulta em alterações dimensionais que conduzem à diminuição em extensão e altura do processo alveolar residual. A preservação/aumento alveolar tem o objetivo de preservar o volume do rebordo e sua geometria, visando uma adequada reabilitação com implantes. Este trabalho teve como objetivo, através de uma revisão da literatura e relato de caso clínico, apresentar a técnica de preservação alveolar com substituto ósseo de hidroxiapatita bovina associado à membrana colágena, de um molar inferior com extensa perda óssea decorrente de periodontite, com acompanhamento clínico de seis meses e posterior reabilitação com implante. O caso foi tratado na clínica do curso de especialização de Periodontia da ABO-PE, no período de julho de 2018 a outubro de 2019. Pôde-se concluir que a associação de hidroxiapatita bovina e membrana colágena para preservação/aumento alveolar em um sítio de molar com extenso comprometimento periodontal consegue obter resultados satisfatórios e seguros na manutenção e regeneração das dimensões ósseas do alvéolo, tanto em altura quanto em espessura, desde que seja realizada a remoção da fonte infecciosa, minuciosa curetagem alveolar e abundante irrigação previamente à colocação do biomaterial.

Palavras-chave – Extração dentária; Preservação do rebordo alveolar; Enxerto ósseo alveolar.

ABSTRACT

The remodeling of the alveolar bone and soft tissues is a physiological response aft er extraction of a dental element. This resorption results in dimensional alterations that lead to the decrease in extension and height of the residual alveolar process. The alveolar ridge preservation/ augumentation is a procedure that aims to preserve alveolar ridge and its geometry, to enable an adequate rehabilitation with dental implants. This paper aims to present a review of the literature and a clinical case report of the alveolar preservation technique with bovine hydroxyapatite bone substitute associated with the collagenous membrane, a lower molar with extensive bone loss due to periodontitis and with clinical follow-up of 6 months and subsequent implant therapy. The clinical case was carried out at the periodontal specialization clinic of the ABO-PE from July 2018 to October 2019. It can be concluded that the association of bovine hydroxyapatite and collagen membrane for alveolar ridge preservation/augumentation in a molar site with extensive periodontal compromise, is able to obtain satisfactory and safe results in the maintenance and regeneration of the bone dimensions of the alveolar both in height and thickness, as long as the removal of the infectious source is carried out, thorough alveolar debridment and abundant irrigation prior to the placement of the biomaterials.

Key words – Tooth extraction; Alveolar ridge preservation; Alveolar bone graft .

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