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Guias cirúrgicas em reabilitação oral com implantes
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Resumo(s)
A reabilitação oral consolidou-se, nas últimas décadas, como uma das soluções fundamentais na reabilitação oral. A integração das tecnologias digitais no planeamento e na execução cirúrgica transformou profundamente a prática clínica, permitindo uma abordagem mais previsível, menos invasiva e melhor adaptada às exigências estéticas e funcionais dos pacientes (Alauddin et al., 2021). Neste contexto, a cirurgia guiada representa um avanço significativo, ao possibilitar a transferência do planeamento virtual para o ato operatório através de guias cirúrgicas concebidas e fabricadas digitalmente (Kernen et al., 2020).
Embora estas soluções prometam elevada precisão no posicionamento dos implantes, observa-se ainda uma variabilidade na sua fiabilidade, dependente de diferentes situações clínicas. Segundo Unsal et al. (2020), apesar dos benefícios associados às guias cirúrgicas CAD/CAM — como maior segurança anatómica e previsibilidade —, persistem limitações relacionadas com a adaptação das guias, o controlo do espaço operatório e a transferência exata do planeamento virtual para o campo clínico.As discrepâncias entre a posição planeada e a posição efetivamente obtida sugerem a influência de múltiplos fatores, nomeadamente relacionados com o paciente, o tipo de suporte da guia, a morfologia óssea e as condições operatórias (Lo Russo et al., 2023).
Compreender de forma aprofundada estes parâmetros é essencial para otimizar a eficácia da cirurgia guiada e assegurar a previsibilidade dos resultados clínicos (Flügge et al., 2022).
Esta revisão narrativa da literatura tem como objetivo analisar os fatores clínicos suscetíveis de influenciar a precisão das guias cirúrgicas em implantologia oral, com base nas evidências disponíveis na investigação contemporânea.
Pretende-se identificar as tendências gerais observadas na literatura, reconhecer as limitações atuais desta técnica e contribuir para uma reflexão abrangente sobre as condições clínicas que favorecem uma utilização mais fiável destas tecnologias na reabilitação oral.
Oral rehabilitation has established itself, over recent decades, as one of the fundamental solutions in oral rehabilitation. The integration of digital technologies into surgical planning and execution has profoundly transformed clinical practice, enabling a more predictable, less invasive approach that is better adapted to patients’ aesthetic and functional demands (Alauddin et al., 2021). In this context, guided surgery represents a significant advance, as it allows the transfer of virtual planning to the operative procedure through surgically guided templates designed and manufactured digitally (Kernen et al., 2020). Although these solutions promise high precision in implant placement, variability in their reliability is still observed, depending on different clinical situations. According to Unsal et al. (2020), despite the benefits associated with CAD/CAM surgical guides — such as greater anatomical safety and predictability — limitations remain regarding guide adaptation, control of the operative space, and the accurate transfer of virtual planning to the clinical field. Discrepancies between the planned position and the position actually achieved suggest the influence of multiple factors, namely those related to the patient, the type of guide support, bone morphology, and operative conditions (Lo Russo et al., 2023).A thorough understanding of these parameters is essential to optimize the effectiveness of guided surgery and ensure the predictability of clinical outcomes (Flügge et al., 2022). This narrative literature review aims to analyze the clinical factors likely to influence the accuracy of surgical guides in oral implantology, based on the evidence available in contemporary research. It seeks to identify the general trends observed in the literature, recognize the current limitations of this technique, and contribute to a comprehensive reflection on the clinical conditions that favor a more reliable use of these technologies in oral rehabilitation.
Oral rehabilitation has established itself, over recent decades, as one of the fundamental solutions in oral rehabilitation. The integration of digital technologies into surgical planning and execution has profoundly transformed clinical practice, enabling a more predictable, less invasive approach that is better adapted to patients’ aesthetic and functional demands (Alauddin et al., 2021). In this context, guided surgery represents a significant advance, as it allows the transfer of virtual planning to the operative procedure through surgically guided templates designed and manufactured digitally (Kernen et al., 2020). Although these solutions promise high precision in implant placement, variability in their reliability is still observed, depending on different clinical situations. According to Unsal et al. (2020), despite the benefits associated with CAD/CAM surgical guides — such as greater anatomical safety and predictability — limitations remain regarding guide adaptation, control of the operative space, and the accurate transfer of virtual planning to the clinical field. Discrepancies between the planned position and the position actually achieved suggest the influence of multiple factors, namely those related to the patient, the type of guide support, bone morphology, and operative conditions (Lo Russo et al., 2023).A thorough understanding of these parameters is essential to optimize the effectiveness of guided surgery and ensure the predictability of clinical outcomes (Flügge et al., 2022). This narrative literature review aims to analyze the clinical factors likely to influence the accuracy of surgical guides in oral implantology, based on the evidence available in contemporary research. It seeks to identify the general trends observed in the literature, recognize the current limitations of this technique, and contribute to a comprehensive reflection on the clinical conditions that favor a more reliable use of these technologies in oral rehabilitation.
Descrição
Dissertação para obtenção do grau de Mestre no Instituto Universitário Egas Moniz
Palavras-chave
Guias cirúrgicas Fatores clínicos Cirurgia guiada Precisão