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Publication
Reabilitação com implantes zigomáticos em maxilar atrófico
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Abstract(s)
As opções terapêuticas na reabilitação oral foram modificadas pela implantologia moderna, permitindo reabilitar áreas parcialmente ou totalmente desdentadas de maneira fixa. Esta reabilitação pode ser complicada pela atrofia do maxilar impedindo a colocação de implantes convencionais. De fato, a reabsorção óssea significativa ao nível da crista alveolar maxilar, resultante do edentulismo, combinado com a pneumatização dos seios maxilares, leva inevitavelmente a uma perda de volume ósseo dificultando a colocação de implantes convencionais, na zona posterior do maxilar. Diferentes tipos de tratamentos podem ser usados para resolver o problema da atrofia, como os enxertos ósseos, provenientes da crista ilíaca ou da abóboda craniana, sendo questionável o seu alto risco de morbilidade.
Durante algum tempo colocou-se a questão se seria possível reabilitar de forma simples, segura e altamente previsível, os casos de maxilares severamente reabsorvidos, nos quais as técnicas clássicas de osteointegração não apresentavam resultados satisfatórios. Percebeu-se que temos, naturalmente, uma área extensa de osso com boa densidade, perto do maxilar e que poderia proporcionar uma fixação dos implantes. Foi desta forma que os implantes zigomáticos surgiram, transformando-se numa alternativa viável face às técnicas cirúrgicas clássicas.
Esta monografia visa fazer uma revisão bibliográfica sobre o estado de arte no que toca às técnicas para colocação de implantes zigomáticos em doentes com maxilares atróficos.
The therapeutic options in respect to oral rehabilitation have been modified by modern implantology, enabling a rehabilitation of partial or total edentulous areas using fixed techniques. This kind of rehabilitation may be difficult due to the maxillary atrophy which may make it impossible to place conventional implants. In fact, a significant bone resorption at the maxillary alveolar crest, resultant from edentulism, combined with pneumatization of the maxillary sinuses will lead, inevitably, to a volume loss in bone which, in turn, becomes inadequate to conventional implant placement, particularly in the posterior region. Different types of treatments can be used to deal with these kinds of atrophy, such as bone grafts taken from the iliac crest or cranial vault, however these techniques are still questionable as of their high risk of morbidity. For some time, the question remained of whether it would be possible or not to rehabilitate in a simple, safe and highly predictable manner, those cases in which patients had severely reabsorbed maxillary, and classic osteointegration techniques wouldn’t had satisfactory results. It was noticed that we have, naturally, an extensive area of good density bone near the maxillary and that it could provide a good area for placement of implants. Thanks to this discovery the zygomatic implants appeared, becoming a valid alternative in contrast to the classic surgical techniques. This monography aims to do a bibliographic review of state-of-the-art techniques in regard to zygomatic implant placement in patients with atrophic maxillary.
The therapeutic options in respect to oral rehabilitation have been modified by modern implantology, enabling a rehabilitation of partial or total edentulous areas using fixed techniques. This kind of rehabilitation may be difficult due to the maxillary atrophy which may make it impossible to place conventional implants. In fact, a significant bone resorption at the maxillary alveolar crest, resultant from edentulism, combined with pneumatization of the maxillary sinuses will lead, inevitably, to a volume loss in bone which, in turn, becomes inadequate to conventional implant placement, particularly in the posterior region. Different types of treatments can be used to deal with these kinds of atrophy, such as bone grafts taken from the iliac crest or cranial vault, however these techniques are still questionable as of their high risk of morbidity. For some time, the question remained of whether it would be possible or not to rehabilitate in a simple, safe and highly predictable manner, those cases in which patients had severely reabsorbed maxillary, and classic osteointegration techniques wouldn’t had satisfactory results. It was noticed that we have, naturally, an extensive area of good density bone near the maxillary and that it could provide a good area for placement of implants. Thanks to this discovery the zygomatic implants appeared, becoming a valid alternative in contrast to the classic surgical techniques. This monography aims to do a bibliographic review of state-of-the-art techniques in regard to zygomatic implant placement in patients with atrophic maxillary.
Description
Dissertação para obtenção do grau de Mestre no Instituto Universitário Egas Moniz
Keywords
Atrofia maxilar Implantes zigomáticos Técnica cirúrgica Complicações