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Cirurgia regenerativa de defeitos alveolares para propósitos reabilitadores
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A perda dentária leva frequentemente à reabsorção óssea, resultando em alterações anatómicas que comprometem tanto a estética quanto a funcionalidade da cavidade oral. Estas mudanças estruturais limitam a possibilidade de colocação de implantes dentários sem intervenções cirúrgicas prévias que visem a regeneração do tecido ósseo. Este trabalho tem como objetivo analisar e descrever as principais técnicas cirúrgicas de regeneração óssea utilizadas na reabilitação de defeitos alveolares, com foco na preparação do leito ósseo para suportar implantes dentários.
Entre as técnicas abordadas, destacam-se a elevação do seio maxilar, a técnica de Khoury, a técnica de Split Crest e a distração osteogénica, que são frequentemente utilizadas para aumentar o volume ósseo em casos de reabsorção severa, através da utilização de diversos biomateriais, como autoenxertos, aloenxertos, xenoenxertos e enxertos aloplásticos, sendo estes selecionados com base nas características individuais do paciente e nas necessidades específicas de cada cirurgia. A importância das membranas reabsorvíveis e não reabsorvíveis para a estabilização do enxerto e proteção do processo regenerativo é sublinhada, assim como o papel de fatores de crescimento, como as BMP’s, PRP e PRF, que têm demonstrado um grande potencial em acelerar a regeneração óssea.
Adicionalmente, são descritas alternativas às técnicas cirúrgicas, como o uso de implantes zigomáticos, pterigóideos, transnasais e subperiosteais, que representam opções viáveis para pacientes com volumes ósseos insuficientes, onde as técnicas convencionais de enxerto podem não ser aplicáveis.
Conclui-se que o sucesso da reabilitação oral em pacientes com atrofia óssea depende de uma seleção criteriosa dos materiais e técnicas, assim como da personalização do tratamento às necessidades específicas de cada paciente. As técnicas de regeneração óssea e as alternativas aqui discutidas continuam a evoluir, graças aos avanços tecnológicos, permitindo a melhoria dos resultados clínicos e a qualidade de vida dos pacientes.
Tooth loss frequently leads to bone resorption, resulting in anatomical changes that compromise both the aesthetics and functionality of the oral cavity. These structural changes limit the possibility of placing dental implants without prior surgical interventions aimed at bone tissue regeneration. This work aims to analyze and describe the main surgical bone regeneration techniques used in the rehabilitation of alveolar defects, focusing on the preparation of the bone bed to support dental implants. Among the techniques discussed, the maxillary sinus lift, Khoury technique, Split Crest technique, and osteogenic distraction stand out, which are frequently used to increase bone volume in cases of severe resorption through the use of various biomaterials, such as autografts, allografts, xenografts, and alloplastic grafts. These materials are selected based on the patient's individual characteristics and the specific needs of each surgery. The importance of resorbable and non-resorbable membranes for graft stabilization and protection of the regenerative process is emphasized, as well as the role of growth factors such as BMPs, PRP, and PRF, which have shown great potential in accelerating bone regeneration. Additionally, alternatives to surgical techniques are described, such as the use of zygomatic, pterygoid, transnasal, and subperiosteal implants, which represent viable options for patients with insufficient bone volumes where conventional grafting techniques may not be applicable. It is concluded that the success of oral rehabilitation in patients with bone atrophy depends on a careful selection of materials and techniques, as well as the personalization of treatment to the specific needs of each patient. The bone regeneration techniques and alternatives discussed here continue to evolve thanks to technological advances, allowing for improved clinical outcomes and patient quality of life.
Tooth loss frequently leads to bone resorption, resulting in anatomical changes that compromise both the aesthetics and functionality of the oral cavity. These structural changes limit the possibility of placing dental implants without prior surgical interventions aimed at bone tissue regeneration. This work aims to analyze and describe the main surgical bone regeneration techniques used in the rehabilitation of alveolar defects, focusing on the preparation of the bone bed to support dental implants. Among the techniques discussed, the maxillary sinus lift, Khoury technique, Split Crest technique, and osteogenic distraction stand out, which are frequently used to increase bone volume in cases of severe resorption through the use of various biomaterials, such as autografts, allografts, xenografts, and alloplastic grafts. These materials are selected based on the patient's individual characteristics and the specific needs of each surgery. The importance of resorbable and non-resorbable membranes for graft stabilization and protection of the regenerative process is emphasized, as well as the role of growth factors such as BMPs, PRP, and PRF, which have shown great potential in accelerating bone regeneration. Additionally, alternatives to surgical techniques are described, such as the use of zygomatic, pterygoid, transnasal, and subperiosteal implants, which represent viable options for patients with insufficient bone volumes where conventional grafting techniques may not be applicable. It is concluded that the success of oral rehabilitation in patients with bone atrophy depends on a careful selection of materials and techniques, as well as the personalization of treatment to the specific needs of each patient. The bone regeneration techniques and alternatives discussed here continue to evolve thanks to technological advances, allowing for improved clinical outcomes and patient quality of life.
Descrição
Dissertação para obtenção do grau de Mestre no Instituto Universitário Egas Moniz
Palavras-chave
Cirurgia Regeneração óssea Defeitos alveolares Reabilitação oral