Alternativas no manejo de tecidos moles para longevidade da saúde peri-implantar: Revisão da literatura

RESUMO

Objetivo: revisar as possíveis alternativas no manejo de tecidos moles na reabilitação de implantes dentários com intuito de preservação tecidual de longo prazo. Material e métodos: as palavras-chave utilizadas neste estudo foram interdental papilla, dental tissue conditioning, dental prosthesis implant-supported, não sendo combinadas. Buscas foram realizadas nas bases de dados eletrônicas PubMed, Scielo e Bireme entre os anos de 2003 e 2021. Os critérios de inclusão foram estudos clínicos randomizados, revisões sistemáticas, metanálises e casos clínicos no idioma inglês. Já os critérios de exclusão foram: carta ao editor e revisão da literatura. Resultados: foram selecionados dez artigos clínicos de caso-controle e quatro artigos de estudo clínico randomizado, três estudos retrospectivos e quatro revisões sistemáticas com metanálise. Os artigos avaliaram os resultados de enxerto gengival livre, de enxerto de tecido conjuntivo e membranas, do uso de ácido hialurônico e de plaquetas ricas em fibrina (PRF), a influência do biotipo/ fenótipo gengival, da peça protética na manutenção do volume da mucosa peri-implantar. Conclusão: o manejo dos tecidos moles peri-implantares é um desafio, e todas as alternativas descritas possuem limitações. Portanto, mais estudos são necessários para avaliar a longevidade estética dos implantes dentários.

Palavras-chave – Papila interdental; Condicionamento tecidual dental; Prótese sobre implante.

ABSTRACT

The objective of this study was to review the possible alternatives in the management of soft tissue in the rehabilitation of dental implants with long-term tissue preservation. The keywords used in this study were interdental papilla, gingival biotype, implantsupported dental prosthesis, not be combined. Databases such as PubMed, Scielo, and Bireme were the sources of the studies, which were between 2003 and 2021. Inclusion criteria were: randomized clinical trials, systematic-review with meta-analyses, and clinical cases. The exclusion criteria were: letters to the editor and literature reviews. There were ten clinical case-control articles and four randomized clinical studies, three retrospective studies, and four systematic-review with meta-analyses. The articles evaluated the results of a free gingival graft, connective tissue, membrane gra s, hyaluronic acid, and fibrin-rich platelets (PRF), the influence of gingival biotype/phenotype, prosthetic piece, in the maintenance of the volume of the peri-implant mucosa. Then, the peri-implant management of soft tissues is a challenge, and all the alternatives described have limitations. Therefore, more studies are needed to assess the aesthetic longevity of dental implants.

Key words – Interdental papilla; Dental tissue conditioning; Dental prosthesis implant-supported.

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