Técnicas cirúrgicas em Implantodontia: convencional e guiada estática – Parte 2

Estudo avalia a precisão cirúrgica da técnica guiada estática e a diferença de desvios entre esta e a técnica convencional.

AUTORES

Talita Suelen de Queiroz
Mestranda do programa de pós-graduação em Odontologia Restauradora – ICT-Unesp.
Orcid: 0000-0001-5523-3280.

Guilherme da Rocha Scalzer Lopes
Especialista em Implantodontia – Unicamp, Pós-doutorando do programa de pós-graduação em Odontologia Restauradora – ICT-Unesp.
Orcid: 0000-0002-4310-0082.

Leonardo Jiro Nomura Nakano
Mestre e doutorando do programa de pós-graduação em Odontologia Restauradora – ICT-Unesp.
Orcid: 0000-0001-6786-862X.

Mateus Favero Barra Grande
Mestre e doutorando do programa de pós-graduação em Odontologia Restauradora – ICT-Unesp.
Orcid: 0000-0002-0996-0847.

Renato Sussumu Nishioka
Professor titular de Implante e Prótese parcial fixa do Depto. de Materiais Odontológicos e Prótese – ICT-Unesp.
Orcid: 0000-0002-1458-601X.

RESUMO

A Implantodontia apresenta alta taxa de sucesso e representa um grande salto evolutivo nas técnicas de reabilitação odontológica. Com o avanço tecnológico, surgiu a técnica da cirurgia guiada estática, que somou avanços e benefícios na Implantodontia. O presente estudo teve como objetivo avaliar, através de uma revisão da literatura, a precisão cirúrgica da técnica guiada estática e a diferença de desvios entre esta e a técnica convencional. Foram realizadas buscas na base de dados PubMed (MEDLINE) filtrando artigos publicados nos últimos cinco anos até outubro de 2020, tendo como critérios de exclusão: artigos que não faziam comparação entre cirurgia guiada e convencional, artigos que comparavam cirurgia navegada e convencional, artigos que indicavam apenas taxas de sucesso – sem discriminar a precisão de cada uma das técnicas. Foram encontrados 405 resultados e selecionados 17 para leitura completa. Destes, seis artigos foram inclusos na análise final. Os resultados demonstraram que a cirurgia totalmente guiada estática apresenta menor taxa de desvio quando comparada à técnica convencional, porém, para que as vantagens da técnica guiada estática sejam obtidas de forma efetiva, é imprescindível que haja atenção em todas as fases do tratamento, uma vez que ela pode ser sensível a erros cumulativos.

Palavras-chave – Cirurgia assistida por computador; Implante dentário; Planejamento de Prótese Dentária; Procedimentos cirúrgicos pré-protéticos bucais; Projeto assistido por computador.

ABSTRACT

Implantology has a high success rate and represents a great evolutionary leap in dental rehabilitation techniques. With technological advances, the static guided surgery technique emerged, with advances and benefits in implant dentistry. The present study aimed to evaluate, through a literature review the surgical precision of the static guided technique and the diff erence in deviations between this and the conventional technique. Searches were performed in the PubMed database (MEDLINE) filtering articles published in the last 5 years until October 2020, with the exclusion criteria: articles that did not compare between guided and conventional surgery, articles where were presented comparisons on navigated and conventional surgery, articles that indicated only success rates, without discriminating the accuracy of each technique. 405 results were found and 17 were selected for full reading. Of these, 6 articles were included in the final analysis. The results showed that fully static guided surgery has a lower rate of deviation when compared to conventional technique, however, in order to obtain maximum benefits from static guided technique advantages, it is essential to pay attention to all the treatment phases, once that it can be sensitive to cumulative errors.

Key words – Computer aided design; Dental implantation; Dental prosthesis design; Oral surgical procedures; Preprosthetic surgery computer-assisted.

Recebido em dez/2021
Aprovado em dez/2021

(Clique aqui e leia também a parte 1 do artigo).

Referências

Oshida Y, Tuna EB, Aktören O, Gençay K. International journal of molecular sciences. Dental Implant Systems 2010;11(4):1580-678.

Clark D, Levin L. In the dental implant era, why do we still bother saving teeth? Dental Traumatology 2019;35(6):368-75.

Steigenga JT, Al-Shammari KF, Nociti FH, Misch CE, Wang HL. Dental implant design and its relationship to long-term implant success. Implant Dent 2003;12(4):306-17.

Colombo M, Mangano C, Mijiritsky E, Krebs M, Hauschild U, Fortin T. Clinical applications and effectiveness of guided implant surgery: a critical review based on randomized controlled trials. BMC Oral Health 2017;17(1):150.

Gupta R, Gupta N, Weber KK. Dental Implants. In: StatPearls. Treasure Island (FL): StatPearls Publishing; August 11, 2020.

Smitkarn P, Subbalekha K, Mattheos N, Pimkhaokham A. The accuracy of single‐tooth implants placed using fully digital‐guided surgery and freehand implant surgery. J Clin Periodontol 2019;46(9):949-57.

Vercruyssen M, Laleman I, Jacobs R, Quirynen M. Computer-supported implant planning and guided surgery: a narrative review. Clin Oral Implants Res 2015;26(suppl.11):69-76.

Greenberg AM. Digital technologies for dental implant treatment planning and guided surgery. Oral Maxillofac Surg Clin North Am 2015;27(2):319-40.

Bover-Ramos F, Viña-Almunia J, Cervera-Ballester J, Peñarrocha-Diago M, García-Mira B. Accuracy of implant placement with computer-guided surgery: a systematic review and meta-analysis comparing cadaver, clinical, and in vitro studies. Int J Oral Maxillofac Implants 2018;33(1):101-15.

Schneider D, Sancho-Puchades M, Mir-Marí J, Mühlemann S, Jung R, Hämmerle C. A randomized controlled clinical trial comparing conventional and computer-assisted implant planning and placement in partially edentulous patients. Part 4: accuracy of implant placement. Int J Periodontics Restor Dent 2019;39(4):e111-22.

Younes F, Cosyn J, De Bruyckere T, Cleymaet R, Bouckaert E, Eghbali A. A randomized controlled study on the accuracy of free‐handed, pilot‐drill guided and fully guided implant surgery in partially edentulous patients. J Clin Periodont 2018;45(6):721-32.

Younes F, Eghbali A, De Bruyckere T, Cleymaet R, Cosyn J. A randomized controlled trial on the efficiency of free‐handed, pilot‐drill guided and fully guided implant surgery in partially edentulous patients. Clin Oral Implant Res 2019;30(2):131-8.

Varga Jr E, Antal M, Major L, Kiscsatári R, Braunitzer G, Piffkó J. Guidance means accuracy: a randomized clinical trial on freehand versus guided dental implantation. Clin Oral Implant Res 2020;31(5):417-30.

Magrin GL, Rafael SN, Passoni BB, Magini RS, Benfatti CA, Gruber R et al. Clinical and tomographic comparison of dental implants placed by guided virtual surgery versus conventional technique: a split‐mouth randomized clinical trial. J Clin Periodontol 2020;47(1):120-8.

Schneider D, Sancho-Puchades M, Benic GI, Hämmerle CH, Jung RE. A randomized controlled clinical trial comparing conventional and computer- assisted implant planning and placement in partially edentulous patients. Part 1: clinician-related outcome measures. Int J Periodontics Restorative Dent 2018;38(suppl.):s49-57.

Marei HF, Abdel-Hady A, Al-Khalifa K, Al-Mahalawy H. Influence of surgeon experience on the accuracy of implant placement via a partially computer-guided surgical protocol. Int J Oral Maxillofac Implants 2019;34(5):1177–83.

El Kholy K, Janner SF, Schimmel M, Buser D. The influence of guided sleeve height, drilling distance, and drilling key length on the accuracy of static computer‐assisted implant surgery. Clin Implant Dent Relat Res 2019;21(1):101-7.