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Publication
A influência da mucosa queratinizada na saúde peri-implantar
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Advisor(s)
Abstract(s)
A saúde peri-implantar e a estética dos tecidos moles são importantes critérios para o sucesso da reabilitação com implantes dentários. Não obstante, a necessidade de uma quantidade mínima de mucosa queratinizada para manutenção da saúde peri-implantar é um assunto controverso que tem vindo a ser debatido na literatura. Alguns autores advogam a importância de uma larga faixa de mucosa queratinizada para a manutenção da saúde peri-implantar, enquanto outros não defendem tal associação, referindo ser possível manter implantes saudáveis, mesmo na presença de quantidades consideradas inadequadas de mucosa queratinizada.
Visando um melhor entendimento deste tema, muitos estudos investigam a relação entre a presença e as dimensões da mucosa queratinizada com vários parâmetros clínicos e radiográficos, tais como o índice de placa, o desconforto à escovagem, o índice gengival, a profundidade de sondagem, a hemorragia à sondagem, a recessão da mucosa e a média da perda óssea peri-implantar. Apesar dos resultados díspares encontrados na literatura, a presença de mucosa queratinizada parece oferecer maior resistência à progressão da doença peri-implantar, além de que, quando numa largura de 2 ou mais milímetros, parece contribuir para o conforto do paciente e para melhores níveis de controlo de placa bacteriana. Assim, aquando do planeamento do tratamento, o clínico deve estar ciente da quantidade de mucosa queratinizada, sendo que, além da finalidade estética, as técnicas de preservação e aumento de mucosa queratinizada peri-implantar possibilitam a correção de quantidades insuficientes desta, contribuindo para a manutenção da saúde e estabilidade peri-implantar.
Posto isto, torna-se clara a necessidade de mais estudos com maior nível de evidência, a fim de definir a influência da mucosa queratinizada na saúde peri-implantar, bem como a importância e momento ideal para execução das técnicas cirúrgicas para aumento da mucosa queratinizada.
Peri-implant health and soft tissue esthetics are important criteria for successful rehabilitation with dental implants. Nevertheless, the need for a minimal amount of keratinized mucosa to maintain peri-implant health is a controversial issue that has been debated in the literature. Some authors argue the importance of a wide band of keratinized mucosa for the maintenance of peri-implant health, while others do not defend such an association, stating that it is possible to maintain peri-implant health, even in the presence of inadequate amounts of keratinized mucosa. Aiming at a better understanding of this topic, many studies investigate the relationship between the presence and dimensions of the keratinized mucosa with various clinical and radiographic parameters, such as plaque index, brushing discomfort, gingival index, probing depth, bleeding on probing, mucosal recession and mean peri-implant bone loss. Despite the disparate results found in the literature, the presence of keratinized mucosa seems to offer greater resistance to the progression of peri-implant disease, in addition to the fact that, when in a width of 2 millimeters or more, it seems to contribute to patient comfort and better levels of plaque control. Thus, when planning the treatment, the clinician must be aware of the amount of keratinized mucosa, and, in addition to aesthetics, the techniques for preserving and increasing the peri-implant keratinized mucosa enable the correction of insufficient amounts of it, contributing to the maintenance of peri-implant health and stability. That said, it is clear the need for further studies with a higher level of evidence, in order to define the influence of the keratinized mucosa on peri-implant health, as well as the importance and ideal time for the execution of surgical techniques for increasing keratinized mucosa.
Peri-implant health and soft tissue esthetics are important criteria for successful rehabilitation with dental implants. Nevertheless, the need for a minimal amount of keratinized mucosa to maintain peri-implant health is a controversial issue that has been debated in the literature. Some authors argue the importance of a wide band of keratinized mucosa for the maintenance of peri-implant health, while others do not defend such an association, stating that it is possible to maintain peri-implant health, even in the presence of inadequate amounts of keratinized mucosa. Aiming at a better understanding of this topic, many studies investigate the relationship between the presence and dimensions of the keratinized mucosa with various clinical and radiographic parameters, such as plaque index, brushing discomfort, gingival index, probing depth, bleeding on probing, mucosal recession and mean peri-implant bone loss. Despite the disparate results found in the literature, the presence of keratinized mucosa seems to offer greater resistance to the progression of peri-implant disease, in addition to the fact that, when in a width of 2 millimeters or more, it seems to contribute to patient comfort and better levels of plaque control. Thus, when planning the treatment, the clinician must be aware of the amount of keratinized mucosa, and, in addition to aesthetics, the techniques for preserving and increasing the peri-implant keratinized mucosa enable the correction of insufficient amounts of it, contributing to the maintenance of peri-implant health and stability. That said, it is clear the need for further studies with a higher level of evidence, in order to define the influence of the keratinized mucosa on peri-implant health, as well as the importance and ideal time for the execution of surgical techniques for increasing keratinized mucosa.
Description
Dissertação para obtenção do grau de Mestre no Instituto Universitário Egas Moniz
Keywords
Mucosa queratinizada Implantes dentários Saúde peri-implantar Peri-implantite