Técnica de tunelização para inserção de membrana e implante imediato para correção de fenestração gengival

RESUMO

Este artigo descreveu o tratamento de um caso de fenestração radicular decorrente de terapia endodôntica na região do dente 33. Foi realizada exodontia atraumática preservando a faixa óssea coronal e apical ao defeito. Prosseguiu-se com a instalação de implante, além de regeneração tecidual e óssea guiada com a utilização de membrana colágena em formato T, inserida através de tunelização e com técnica de sutura própria. A resolução clínica deste caso deu-se, entre outros fatores, através da técnica de escolha para inserção e sutura da membrana colágena, que permitiu sua fixação à mucosa e a cobertura da fenestração sem a elevação de retalho, favorecendo a regeneração tecidual. O fenômeno chamado creeping attachment, embora imprevisível, pode ter contribuído para o desfecho favorável ao longo do tempo do presente caso. A técnica para inserção e sutura da membrana colágena com tunelização escolhida foi favorável para o fechamento da lesão de fenestração. No entanto, mais estudos clínicos similares são necessários para ratificar a reprodutibilidade e eficácia da técnica relatada.

Palavras-chave – Regeneração tecidual guiada; Implantes dentários; Técnicas de sutura; Fenestração gengival.

ABSTRACT

This paper describes the treatment of a case of root fenestration resulting from endodontic treatment in the region of tooth 33. After atraumatic tooth extraction has been performed, the coronal and apical bone regions to the defect were preserved. This was followed by the installation of a dental implant, in addition to guided tissue and bone regeneration using a T-shaped collagen membrane, inserted through tunneling and using a specific suturing technique. The clinical resolution of this case occurred, among other factors, through the chosen technique for insertion and suturing of the collagenous membrane, which allowed its fixation to the mucosa and coverage of the fenestration without flap elevation, favoring tissue regeneration. The phenomenon of creeping attachment, although unpredictable, may have contributed to the favorable outcome over time in the present case. The technique for insertion and suture of the collagen membrane with tunneling chosen was favorable for closing the fenestration lesion. However, more similar clinical studies are needed to confirm the reproducibility and efficacy of the reported technique.

Key words – Guided tissue regeneration; Dental implants; Suture techniques; Root fenestration.

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