Category: Implantology
Autors: Duarte F., Ramos C.
Reference: Rev Port Estomat Med Dent Cirurg Maxilofac 2005; 46(3):157-163
ISSN: 1646-2890
Abstract: The clinical measurement of implant stability and osseointegration is important to be able to assess success, and yet it is largely empirical and subjective in nature. Initial stability of an implant fixture at the time of placement is often assessed by judging the presence of any mobility and bone quality is ranked on a scale (0-4) according to the degree of bone density and drilling resistance experienced by the surgeon.
Following healing and bone formation at the implant-tissue interface, the degree of stability or osseointegration is often assessed by percussing an implant with a blunt instrument such as a mirror handle and trying to elicit any mobility by moving the fixture. Although these are widely practised clinical techniques, there is little evidence in the literature supporting these concepts. There is therefore a clearly perceived need for a quantitative method to measure implant stability. Such a measurement may enable the bone quality and primary implant stability to be assessed at the time of fixture placement, providing a baseline measurement and an indication of an appropriate healing period.
A non-invasive test method to measure implant stability has recently been described by Meredith et al. This technique called Osstell® measures the resonance frequency of a small transducer which may be attached to an implant fixture or abutment.
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Excelência Clínica em Implantodontia – Capítulo 13
A reabilitação da função orofacial de pacientes parcial e totalmente edêntulos, antes do advento do conceito da osseointegração, era efetuada com próteses removíveis. Em 1965, foram usados pela primeira vez implantes osseointegráveis para tratar pacientes edêntulos.
As técnicas de osseointegração para reabilitação maxilar são mais complexas que as de reabilitação mandibular, devido à proximidade das cavidades nasais e seios maxilares, ao grau de reabsorção óssea maxilar (em particular na região posterior por exodontias precoces, pneumatização dos seios maxilares) e à qualidade do osso maxilar, mais vascularizado e menos denso que o osso mandibular.1 Os pacientes com disponibilidade óssea maxilar adequada são excepções, a maioria apresenta graus de atrofia diferentes que obrigam ao recurso de técnicas alternativas de uso do osso existente (p. ex., implante pterigoide), recurso de enxertos ósseos autógenos ou aloplásticos (p. ex., enxertos ósseos onlay na maxila, enxertos ósseos do seio maxilar) ou técnicas osseogênicas de distracção (p. ex., fratura maxilar Le Fort I).
Implantes Zygoma – Limites de Reabilitação
A reabilitação da maxila edêntula extremamente atrófica, comporta um grande desafio cirúrgico e protético, para os profissionais que se dedicam a esta área.