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Tratamento cirúrgico da peri-implantite : revisão da literatura
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Advisor(s)
Abstract(s)
Introdução: Embora os implantes dentários apresentem uma elevada taxa de sucesso e sobrevivência, a ocorrência de complicações, como doenças peri-implantares (mucosite peri-implantar e peri-implantite), não pode ser desconsiderada. (Schwarz, Derks, Monje, Wang, 2018). As meta-análises apresentadas na revisão sistemática de Derks & Tomasi (2015) estimaram prevalências ponderadas de mucosite peri-implantar e peri-implantite de 43% e 22%, respetivamente (Derks & Tomasi, 2015). Enquanto a mucosite peri-implantar se caracteriza pela inflamação dos tecidos moles que circundam o implante (Lindhe et al.,2008; Smeets et al.,2014; Robertson et al, 2015) a peri-implantite é caracterizada pela inflamação dos tecidos moles peri-implantares, acompanhada de perda de osso de suporte (Schwarz, et al.,2018). Aquando da presença desta patologia, o tratamento passa sempre por uma fase não cirúrgica. No entanto, esta nem sempre tem resultados positivos, o que faz com que seja necessária abordagem cirúrgica (Smeets et al., 2014). Neste campo existem inúmeras abordagens tais como: cirurgia de acesso e desbridamento, cirurgia ressectiva, cirurgia regenerativa (Figuero et al., 2014; Mahato et al., 2016).
Objetivo: O objetivo deste trabalho foi avaliar a bibliografia existente sobre técnicas cirúrgicas no tratamento da peri-implantite, analisando resultados a curto e longo prazo, para determinar a abordagem mais adequada para cada caso.
Materiais e Métodos: A literatura utilizada foi obtida através de uma pesquisa eletrónica na base de dados MEDLINE via PubMed, Scielo, Cochrane e Google Scholar e foram também utilizados repositórios universitários, livros e bibliotecas. Foram selecionados artigos de revisão sistemática, meta-análises, estudos clínicos randomizados e controlados (RCTs). A literatura utilizada foi datada entre 2000 a 2024 e podendo ser na língua portuguesa, espanhola ou inglesa.
Conclusão: Os resultados das técnicas cirúrgicas abordadas nesta tese dependem de vários fatores, sendo fundamental a abordagem personalizada em cada caso. A combinação dessas técnicas com terapias adjuvantes e a manutenção rigorosa do paciente são cruciais para o sucesso a longo prazo.
Introduction: Although dental implants have a high success and survival rate, complications such as peri-implant diseases (peri-implant mucositis and peri-implantitis) cannot be disregarded (Schwarz, Derks, Monje, Wang, 2018). Meta-analyses presented in the systematic review by Derks & Tomasi (2015) estimated weighted prevalence rates of peri-implant mucositis and peri-implantitis at 43% and 22%, respectively (Derks & Tomasi, 2015). While peri-implant mucositis is characterized by inflammation of the soft tissues surrounding the implant (Lindhe et al., 2008; Smeets et al., 2014; Robertson et al., 2015), peri-implantitis involves both soft tissue inflammation and supporting bone loss (Schwarz et al., 2018). Treatment for this condition typically begins with a non-surgical phase. However, this approach does not always yield positive results, often necessitating surgical intervention (Smeets et al., 2014). Several surgical techniques are available, including access surgery with debridement, resective surgery, and regenerative surgery (Figuero et al., 2014; Mahato et al., 2016). Objectives: The aim of this study was to evaluate the existing literature on surgical techniques for the treatment of peri-implantitis, analyzing short- and long-term outcomes to determine the most appropriate approach for each case. Materials and Methods: The literature used was obtained through an electronic search in the MEDLINE database via PubMed, Scielo, Cochrane, and Google Scholar. University repositories, books, and libraries were also utilized. Systematic review articles, meta-analyses, and randomized controlled clinical trials (RCTs) were selected. The literature covered was dated between 2000 and 2024 and could be in Portuguese, Spanish, or English. Conclusion: The outcomes of the surgical techniques discussed in this thesis depend on various factors, making a personalized approach crucial in each case. The combination of these techniques with adjuvant therapies and the strict maintenance of the patient are crucial for long-term success.
Introduction: Although dental implants have a high success and survival rate, complications such as peri-implant diseases (peri-implant mucositis and peri-implantitis) cannot be disregarded (Schwarz, Derks, Monje, Wang, 2018). Meta-analyses presented in the systematic review by Derks & Tomasi (2015) estimated weighted prevalence rates of peri-implant mucositis and peri-implantitis at 43% and 22%, respectively (Derks & Tomasi, 2015). While peri-implant mucositis is characterized by inflammation of the soft tissues surrounding the implant (Lindhe et al., 2008; Smeets et al., 2014; Robertson et al., 2015), peri-implantitis involves both soft tissue inflammation and supporting bone loss (Schwarz et al., 2018). Treatment for this condition typically begins with a non-surgical phase. However, this approach does not always yield positive results, often necessitating surgical intervention (Smeets et al., 2014). Several surgical techniques are available, including access surgery with debridement, resective surgery, and regenerative surgery (Figuero et al., 2014; Mahato et al., 2016). Objectives: The aim of this study was to evaluate the existing literature on surgical techniques for the treatment of peri-implantitis, analyzing short- and long-term outcomes to determine the most appropriate approach for each case. Materials and Methods: The literature used was obtained through an electronic search in the MEDLINE database via PubMed, Scielo, Cochrane, and Google Scholar. University repositories, books, and libraries were also utilized. Systematic review articles, meta-analyses, and randomized controlled clinical trials (RCTs) were selected. The literature covered was dated between 2000 and 2024 and could be in Portuguese, Spanish, or English. Conclusion: The outcomes of the surgical techniques discussed in this thesis depend on various factors, making a personalized approach crucial in each case. The combination of these techniques with adjuvant therapies and the strict maintenance of the patient are crucial for long-term success.
Description
Dissertação para obtenção do grau de Mestre no Instituto Universitário Egas Moniz
Keywords
Peri-implantite Regeneração óssea Cirurgia ressectiva Tratamento da peri-implantite