Manejo de tecido mole em área peri-implantar

AUTORAS

Mariane Fontana Mezoni
Graduanda em Odontologia – Centro Universitário Unisep.
Orcid: 0000-0002-4329-3152.

Marta Aparecida Alberton Nuernberg
Professora doutora do curso de Odontologia – Centro Universitário Unisep.
Orcid: 0000-0003-2167-9772.

RESUMO

A manutenção dos tecidos periodontais em torno dos implantes tornou-se uma medida indispensável para assegurar a saúde e a estética esperadas ao final da reabilitação. Estudos têm relacionado a quantidade adequada de mucosa queratinizada como fator de proteção e resistência contra traumas mecânicos e biológicos à mucosa peri-implantar. Dessa forma, o presente trabalho teve como objetivo relatar um caso clínico de aumento de tecido queratinizado (TQ) em área peri-implantar utilizando enxerto gengival livre (EGL). Paciente do sexo feminino com 57 anos de idade, ASA II, tinha um implante dentário instalado há seis meses na região do 24. No exame clínico, constatou-se uma espessura inadequada de TQ, assim como fenótipo periodontal fino na área peri-implantar. Levando em consideração as características clínicas do caso, foi indicada a modificação de fenótipo gengival peri-implantar por meio de EGL. A escolha da abordagem cirúrgica foi direcionada pela fase de condicionamento gengival com cicatrizador em que a paciente se encontrava. O enxerto foi obtido do palato. No acompanhamento pós-operatório de 30 dias, foi observado um ganho de tecido queratinizado > 2 mm com proteção completa da área peri-implantar e relato de maior conforto durante a higienização. A técnica de EGL empregada demonstrou resultados satisfatórios, com ganho expressivo de TQ, além da consequente melhora na estabilidade tecidual, segurança e saúde peri-implantar.

Palavras-chave – Implantes dentários; Placa bacteriana; Fenótipo; Enxerto de tecidos.

ABSTRACT

The maintenance of peri-implant soft tissues has become an essential measure to ensure the health and esthetics expected at the end of implant rehabilitation. Studies have related the adequate amount of keratinized mucosa as a protection and resistance factor against mechanical and biological trauma to the peri-implant mucosa. Thus, the present study aimed to report a clinical case of increase in keratinized tissue (KT) in the peri-implant area using free gingival graft (FGG). A 57-year-old female patient, with dental implant installed 6 months ago in the 24 region. The clinical examination revealed an inadequate thickness of KT, as well as a thin periodontal phenotype in the peri-implant area. Considering the clinical characteristics of the case, the modification of the periimplant gingival phenotype through FGG was indicated. The choice of surgical approach was guided by the gingival conditioning phase with the healing abutment. The graft was taken from the palate. In the 30-day postoperative follow-up, a gain of > 2 mm of KT was observed, with complete protection of the peri-implant area and a report of greater comfort during cleaning. The FGG technique employed showed satisfactory results, with expressive KT gain, in addition to the consequent improvement in tissue stability, safety and peri-implant health.

Key words – Dental implants; Dental plaque; Phenotype; Tissue transplantation.

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