Quando e porque utilizar pilares intermediários ou abutments UCLA em próteses aparafusadas sobre implantes?

Abstract

The aim of this study was to compare through a literature review the indications, no indications, advantages, disadvantages, predictability and applicability of using intermediaries and abutment UCLA (Universal Long castable abutment) screwed into implant prostheses. For this purpose, we performed a literature review of textbooks, classic articles and a systematic search in Capes website (www.periodicos.capes.gov.br). It was concluded that the definition by the use of intermediate pillars or abutment UCLA in prosthesis screwed on implants should be based on conditions such as: available inter-occlusal and interproximal space, level of the gingival tissue; angulation of the implant, prosthesis cost. The use of intermediate pillars is indicated in the presence of a very deep and angled implants. The use of the abutment UCLA is indicated when the interocclusal distance and height of the gingival tissue is limited. The abutment UCLA burnout does not show good fit to the implant platform after casting, favoring plaque accumulation and peri-implantitis. However, the abutment UCLA with metal base provides optimal adaptation. The alloy with overcasting procedure compatible with the base does not change the quality of this adaptation. It is also concluded that there is no scientific evidence to indicate or don´t indicate the use of the abutment UCLA as a single component in screwed prostheses on implants, either for mechanical or biological problems. Clinical studies are still needed to reduce any doubts about the issue presented here. the exact importance to the planning of the case, with regard to the type of prosthesis you want to make, the correct three-dimensional positioning of the implants, the correct amount and distribution of the implants over the arch, and the correct choice for the type of implant seems to be more important than the definition of the type of component to be used in a clinical situation, particularly with regard to the type of connection.