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Taxa de sucesso dos implantes dentários colocados sobre enxertos livres de perónio em pacientes com neoplasia oral, submetidos a cirurgia ablativa : revisão sistemática
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Advisor(s)
Abstract(s)
Objetivo: Avaliar a taxa de sucesso e o rácio de incidência (RI) de insucesso da colocação de implantes sobre retalhos ou enxertos de perónio, em pacientes com neoplasia oral, submetidos a cirurgia ablativa dos maxilares.
Métodos: A pesquisa recorreu a 3 bases de dados eletrónicas: PubMed, B-on e Scopus. Utilizou-se a ferramenta Rayyan para exportar as referências e eliminar as réplicas. Aos resultados aplicaram-se os critérios de inclusão e exclusão. Para a avaliação do risco de enviesamento utilizaram-se as ferramentas JBI para estudos coorte e série de casos. Os valores da taxa de sucesso foram transformados em RI. Efetuaram-se meta-análises, meta-análise de subgrupo e meta-regressões para a taxa de sucesso e RI. Utilizou-se um modelo meta-analítico binário, ajustado através do método DerSimonian e Laird (1986).
Resultados: A pesquisa alcançou 1380 resultados. Após seleção, 18 artigos foram considerados elegíveis de acordo com os critérios de inclusão e exclusão. Os fatores idade média, rácio M/F, longitude, latitude, número de implantes/pessoa, rácio maxila/total, número de pacientes com tumores malignos, parâmetros relacionados com radioterapia (RT) e barra dupla demonstraram não ter impacto na taxa de sucesso e RI. Na reconstrução primária, colocação secundária e carga tardia, embora o efeito seja significativo, está associada heterogeneidade elevada e, consequentemente há discordância entre os estudos. Apenas a distração osteogénica vertical (DOV) influenciou negativamente a taxa de sucesso.
Conclusão: A inserção de implantes em retalhos ou enxertos de perónio, em pacientes com neoplasias, demonstrou ser uma técnica adequada com RI de 0,003 e taxa de sucesso de 88 %, sendo a última inferior relativamente aos implantes colocados sobre osso nativo. Não se encontraram nos estudos fatores que influenciassem significativamente a taxa de sucesso ou o RI, à exceção da DOV. São necessários mais estudos randomizados, com um maior período de follow-up, número de implantes e de participantes.
Objective: Study the success rate and the incidence of implant failure ratio (IR) in oral rehabilitation with implants over grafts or fibula flaps, in patients with head and neck neoplasms, evaluate the ablative surgery of the jaws. Methods: A search used 3 electronic databases: PubMed, B-on and Scopus. Use a Rayyan tool to export the references and eliminate the replicas. The inclusion and exclusion criteria were applied to the results. To assess the risk of bias, the JBI tools for cohort and case series studies were used. Success rate values were transformed into RI. Meta-analyses, subgroup meta-analysis and meta-regressions for success rate and RI were performed. A binary meta-analytical model was used, through the method DerSimonian and Laird (1986). Results: The search achieved 1380 results. After selection, 18 articles were considered eligible according to the inclusion and exclusion criteria. The factors mean age, M/F ratio, longitude, latitude, number of implants/person, maxilla/total ratio, number of patients with malignant tumors, radiotherapy-related parameters and double bar were shown to have no impact on the success rate and IR. In primary reconstruction, secondary placement and late loading, although the effect is significant, high heterogeneity is associated and, consequently, there is disagreement between studies. Only vertical distraction osteogenesis (DOV) negatively influenced the success rate. Conclusion: Insertion of implants in fibula flaps or grafts, in patients with neoplasms, proved to be an adequate technique with RI of 0,003 and a success rate of 88 %, the last is lower than implants placed on native bone. No factors were found in the studies that significantly influenced the success rate or the RI, with the exception of the DOV. More randomized studies are need, with a longer follow-up period, number of implants and number of participants.
Objective: Study the success rate and the incidence of implant failure ratio (IR) in oral rehabilitation with implants over grafts or fibula flaps, in patients with head and neck neoplasms, evaluate the ablative surgery of the jaws. Methods: A search used 3 electronic databases: PubMed, B-on and Scopus. Use a Rayyan tool to export the references and eliminate the replicas. The inclusion and exclusion criteria were applied to the results. To assess the risk of bias, the JBI tools for cohort and case series studies were used. Success rate values were transformed into RI. Meta-analyses, subgroup meta-analysis and meta-regressions for success rate and RI were performed. A binary meta-analytical model was used, through the method DerSimonian and Laird (1986). Results: The search achieved 1380 results. After selection, 18 articles were considered eligible according to the inclusion and exclusion criteria. The factors mean age, M/F ratio, longitude, latitude, number of implants/person, maxilla/total ratio, number of patients with malignant tumors, radiotherapy-related parameters and double bar were shown to have no impact on the success rate and IR. In primary reconstruction, secondary placement and late loading, although the effect is significant, high heterogeneity is associated and, consequently, there is disagreement between studies. Only vertical distraction osteogenesis (DOV) negatively influenced the success rate. Conclusion: Insertion of implants in fibula flaps or grafts, in patients with neoplasms, proved to be an adequate technique with RI of 0,003 and a success rate of 88 %, the last is lower than implants placed on native bone. No factors were found in the studies that significantly influenced the success rate or the RI, with the exception of the DOV. More randomized studies are need, with a longer follow-up period, number of implants and number of participants.
Description
Dissertação para obtenção do grau de Mestre no Instituto Universitário Egas Moniz
Keywords
Implantes dentários Enxerto de perónio Retalho de perónio Cancro oral