Reabilitação oral com levantamento de seio maxilar e próteses implantossuportadas – relato de caso com três anos de acompanhamento

RESUMO

Este artigo descreveu o tratamento de um paciente com 54 anos de idade após dez anos de uso de próteses totais na maxila e na mandíbula. Após exame clínico (Classe VI de Cawood e Howell) e concordância com o plano de tratamento, o levantamento bilateral do seio maxilar foi realizado e um biomaterial xenógeno (partículas 0,25-1 mm) foi acomodado. Seis meses depois, oito implantes dentários (diâmetros de 3,75 mm e 5 mm; comprimentos de 7 mm e 13 mm) foram posicionados nas regiões anterior (11/21) e posterior (13/23, 15/25 e 16/26) seguindo-se as imagens de TCFC e planejamento protético. Na mandíbula, quatro implantes de 3,75 x 13 mm foram colocados entre os forâmens. Em seguida, as próteses totais parafusadas foram instaladas respeitando-se os tempos de cicatrização e acompanhadas durante três anos, sem intercorrências observadas.

Palavras-chave – Levantamento do assoalho do seio maxilar; Implantes dentários; Prótese dentária; Reabilitação bucal.

ABSTRACT

This article describes the treatment of a 54 years-old patient a er 10 years of use of complete dentures in the maxilla and mandible. A er clinical examination (Cawood and Howell´s Class VI) and agreement with the treatment planning, bilateral maxillary sinus li ing procedures were performed and a xenogeneic biomaterial (0.25-1 mm particle size) was accommodated. Six months later, eight dental implants (3.75 mm and 5 mm diameters; 7 mm and 13 mm lengths) were positioned in the anterior (11/21) and posterior (13/23, 15/25, 16/26) regions, following CBCT images and prosthodontic prescriptions. In the mandible, four dental implants (3.75 mm x 13 mm) were installed between the mental foramina. Then, screw-retained, complete, total Þ xed dentures were installed respecting the healing times and followed-up for three years, with no complications observed.

Key words – Sinus ß oor augmentation; Dental implants; Dental prosthesis; Mouth rehabilitation.

Referências

Lajnert V, Pavicic DK, Pavlic A, Pokrajac-Bulian A, Spalj S. Smile aesthetics satisfaction scale: development and validation of a new brief five-item measure of satisfaction with smile aesthetics in adults and the elderly. Int Dent J 2018;68(3):162-70.

Wallace SS, Tarnow DP, Froum SJ, Cho SC, Zadeh HH, Stoupel J et al. Maxillary sinus elevation by lateral window approach: evolution of technology and technique. J Evid Based Dent Pract 2012;12(3 suppl.):161-71.

Buser D, Sennerby L, De Bruyn H. Modern implant dentistry based on osseointegration: 50 years of progress, current trends and open questions. Periodontol 2000 2017;73(1):7-21.

da Silva HF, Goulart DR, Sverzut AT, Olate S, de Moraes M. Comparison of two anorganic bovine bone in maxillary sinus lift: a split-mouth study with clinical, radiographical, and histomorphometrical analysis. Int J Implant Dent 2020;6(1):17.

Serra e Silva FM, Mazzonetto R. Avaliação clínica e histológica da associação de enxerto ósseo bovino e proteína óssea morfogenética em levantamento de seio maxilar. ImplantNews 2006;3(4):377-82.

Mohan N, Wolf J, Dym H. Maxillary sinus augmentation. Dental clinics of North America 2015;59(2):375-88.

Starch-Jensen T, Mordenfeld A, Becktor JP, Jensen SS. Maxillary sinus floor augmentation with synthetic bone substitutes compared with other grafting materials: a systematic review and meta-analysis. Implant Dent 2018;27(3):363-74.

Fillingham Y, Jacobs J. Bone grafts and their substitutes. Bone Joint J 2016;98-B(1 suppl.A):6-9.

Lopez CS, Saka CH, Rada G, Valenzuela DD. Impact of fixed implant supported prostheses in edentulous patients: protocol for a systematic review. BMJ Open 2016;6(2):e009288.

Tsigarida A, Chochlidakis K. A comparison between fixed and removable mandibular implant-supported full-arch prostheses: an overview of systematic reviews. Int J Prosthodont 2021;34:s85-s92.

Cawood JI, Howell RA. A classification of the edentulous jaws. Int J Oral Maxillofac Surg 1988;17(4):232-6.

Antonoglou GN, Stavropoulos A, Samara MD, Ioannidis A, Benic GI, Papageorgiou SN et al. Clinical performance of dental implants following sinus floor augmentation: a systematic review and meta-analysis of clinical trials with at least 3 years of follow-up. Int J Oral Maxillofac Implants 2018;33(3):e45-e65.

Crespi R, Toti P, Covani U, Crespi G, Menchini-Fabris GB. Clinical and radiographic evaluation of modified transalveolar two-step osteotome-mediated localized maxillary sinus elevation: a retrospective computed tomography study with a 3-year follow-up. Int J Oral Maxillofac Implants 2021;36(3):553-60.

Díaz-Olivares LA, Brinkmann JC-B, Martínez-Rodríguez N, Martínez-González JM, López-Quiles J, Leco-Berrocal I et al. Management of Schneiderian membrane perforations during maxillary sinus floor augmentation with lateral approach in relation to subsequent implant survival rates: a systematic review and meta-analysis. Int J Implant Dent 2021;7(1):91.

Sakkas A, Wilde F, Heufelder M, Winter K, Schramm A. Autogenous bone grafts in oral implantology-is it still a “gold standard”? A consecutive review of 279 patients with 456 clinical procedures. Int J Implant Dent 2017;3(1):23.

Cosso MG, de Brito Jr. RB, Piattelli A, Shibli JA, Zenobio EG. Volumetric dimensional changes of autogenous bone and the mixture of hydroxyapatite and autogenous bone graft in humans maxillary sinus augmentation. A multislice tomographic study. Clin Oral Implants Res 2014;25(11):1251-6.

Cosmo LAM, de Macedo LGS, Pelegrine AA, de Macedo NL. Enxerto ósseo em levantamento de seio maxilar com osso humano fresco congelado. ImplantNews 2007;4(4):385-90.

Jensen T, Schou S, Svendsen PA, Forman JL, Gundersen HJ, Terheyden H et al. Volumetric changes of the graft after maxillary sinus floor augmentation with Bio-Oss and autogenous bone in different ratios: a radiographic study in minipigs. Clin Oral Implants Res 2012;23(8):902-10.

Tosta M, Saraceni CHC, Barbosa J, Guerra L, Ferraz P, de Moura Filho GS et al. Avaliação clínica e histológica da eficácia de um substituto ósseo em enxertos no seio maxilar em humanos. ImplantNews 2007;4(5):479-89.

Chanavaz M. Maxillary sinus: anatomy, physiology, surgery, and bone grafting related to implantology – eleven years of surgical experience (1979-1990). J Oral Implantol 1990;16(3):199-209.

Davies JE. Understanding peri-implant endosseous healing. J Dent Educ 2003;67(8):932-49.

Taruna M, Chittaranjan B, Sudheer N, Tella S, Abusaad M. Prosthodontic perspective to all-on-4® concept for dental implants. J Clin Diag Res 2014;8(10):Ze16-9.

Polido WD, Aghaloo T, Emmett TW, Taylor TD, Morton D. Number of implants placed for complete-arch fixed prostheses: a systematic review and meta-analysis. Clin Oral Implants Res 2018;29(suppl.16):154-83.

Gomes JML, Lemos CAA, Santiago Junior JF, de Moraes SLD, Goiato MC, Pellizzer EP. Optimal number of implants for complete-arch implant-supported prostheses with a follow-up of at least 5 years: a systematic review and meta-analysis. J Prosthet Dent 2019;121(5):766-74.e3.

Bedrossian E, Bedrossian EA. Implant-supported vs. tissue-supported prosthesis: biomechanical principles for fixed full-arch restorations. Compend Contin Educ Dent 2019;40(8):524-9.

De Kok IJ, Chang KH, Lu TS, Cooper LF. Comparison of three-implant-supported fixed dentures and two-implant-retained overdentures in the edentulous mandible: a pilot study of treatment efficacy and patient satisfaction. Int J Oral Maxillofac Implants 2011;26(2):415-26.

Kern JS, Kern T, Wolfart S, Heussen N. A systematic review and meta-analysis of removable and fixed implant-supported prostheses in edentulous jaws: post-loading implant loss. Clin Oral Implants Res 2016;27(2):174-95.

Retzepi M, Donos N. Guided bone regeneration: biological principle and therapeutic applications. Clin Oral Implants Res 2010;21(6):567-76.

Weinberg LA. The biomechanics of force distribution in implant-supported prostheses. Int J Oral Maxillofac Implants 1993;8(1):19-31.