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Comparação da taxa de sucesso na osteointegração de implantes dentários colocados com cirurgia guiada vs cirurgia não guiada : Uma revisão narrativa
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Abstract(s)
A osteointegração de implantes dentários é um dos principais fatores determinantes para o sucesso em reabilitações orais. A evolução tecnológica permitiu o desenvolvimento da cirurgia guiada, que se baseia no planeamento digital e imagiologia tridimensional para otimizar a colocação de implantes. Esta abordagem tem demonstrado maior precisão e previsibilidade em comparação com a técnica tradicional à mão livre.
A cirurgia guiada permite uma execução mais controlada, com menores desvios tridimensionais e possibilidade de cirurgias menos invasivas, como a técnica sem retalho. Estas características promovem uma recuperação mais rápida e confortável para o paciente. Além disso, a sua integração com o planeamento protético favorece a emergência ideal das próteses, reduzindo complicações biológicas e melhorando os resultados estéticos e funcionais.
Apesar das suas vantagens, a cirurgia guiada apresenta limitações, como custos elevados, curva de aprendizagem acentuada e contraindicações em casos com anatomia ou abertura bucal reduzida. A cirurgia não guiada, por outro lado, mantém-se como uma opção válida, especialmente quando executada por profissionais experientes, apresentando também elevadas taxas de sucesso clínico.
Estudos indicam que, embora ambas as técnicas possam alcançar bons resultados, a cirurgia guiada mostra-se superior em cenários que exigem maior precisão, como reabilitações totais com carga imediata e implantes pós-extracionais. A decisão pela técnica mais adequada deve considerar as particularidades de cada caso, integrando fatores anatómicos, sistémicos e tecnológicos.
Assim, a cirurgia guiada consolida-se como uma ferramenta estratégica na prática clínica moderna, contribuindo para uma implantologia mais segura, previsível e orientada para a excelência funcional e estética.
Osseointegration of dental implants is one of the main determining factors for successful oral rehabilitation. Technological advances have led to the development of guided surgery, which relies on digital planning and three-dimensional imaging to optimize implant placement. This approach has shown greater accuracy and predictability compared to the traditional freehand technique. Guided surgery allows for more controlled execution, with reduced three-dimensional deviations and the possibility of less invasive procedures, such as flapless techniques. These features promote faster and more comfortable patient recovery. Moreover, its integration with prosthetic planning supports optimal prosthetic emergence, reducing biological complications and improving both aesthetic and functional outcomes. Despite its advantages, guided surgery presents some limitations, such as high costs, a steep learning curve, and contraindications in cases with compromised anatomy or limited mouth opening. Freehand surgery, on the other hand, remains a valid option, particularly when performed by experienced clinicians, also achieving high clinical success rates. Studies indicate that although both techniques can yield good outcomes, guided surgery proves to be superior in scenarios requiring higher precision, such as full-arch immediate load rehabilitations and post-extraction implant placements. The decision on the most appropriate technique should consider the specific characteristics of each clinical case, integrating anatomical, systemic, and technological factors. Thus, guided surgery is established as a strategic tool in modern clinical practice, contributing to safer, more predictable implantology focused on functional and aesthetic excellence.
Osseointegration of dental implants is one of the main determining factors for successful oral rehabilitation. Technological advances have led to the development of guided surgery, which relies on digital planning and three-dimensional imaging to optimize implant placement. This approach has shown greater accuracy and predictability compared to the traditional freehand technique. Guided surgery allows for more controlled execution, with reduced three-dimensional deviations and the possibility of less invasive procedures, such as flapless techniques. These features promote faster and more comfortable patient recovery. Moreover, its integration with prosthetic planning supports optimal prosthetic emergence, reducing biological complications and improving both aesthetic and functional outcomes. Despite its advantages, guided surgery presents some limitations, such as high costs, a steep learning curve, and contraindications in cases with compromised anatomy or limited mouth opening. Freehand surgery, on the other hand, remains a valid option, particularly when performed by experienced clinicians, also achieving high clinical success rates. Studies indicate that although both techniques can yield good outcomes, guided surgery proves to be superior in scenarios requiring higher precision, such as full-arch immediate load rehabilitations and post-extraction implant placements. The decision on the most appropriate technique should consider the specific characteristics of each clinical case, integrating anatomical, systemic, and technological factors. Thus, guided surgery is established as a strategic tool in modern clinical practice, contributing to safer, more predictable implantology focused on functional and aesthetic excellence.
Description
Dissertação para obtenção do grau de Mestre no Instituto Universitário Egas Moniz
Keywords
Osteointegração Implante Cirurgia guiada Cirurgia não guiada