Implantes em área de osso comprometido: quantidade e qualidade

Abstract

The general objective of this monograph was to characterize the compromised bone tissue in healthy individuals and in individuals with systemic changes which affect the bone metabolism, as well as the behavior of osseointegrated implants in these different clinical situations. In the literature review were accessed PubMed, Cochrane, Dentistry, Oral Science SciELO and Bireme databases, giving preference to the latest articles, but not ignoring traditional understandings of Dentistry. The topics of the approach involved the bone quality/quantity for implant installation, information about the causes of compromised bone tissue and solutions for the installation of implants in bone areas engaged in healthy and compromised individuals because systemically changes in physiological conditions can generate a significant impact on the treatment prognosis and outcome. Were characterized osteogenesis imperfecta, hyperparathyroidism, osteoporosis, fibrous dysplasia, cemento-osseous dysplasia, Paget's disease, multiple myeloma, bone irradiated by radiation and diseases which require treatment with bisphosphonates (osteoporosis, Paget, metastatic bone neoplasm, breast cancer, multiple myeloma, hypercalcemia). It is concluded that the quality and quantity of bone available at the site of the implant are very important factors in determining the therapy success. If in healthy individuals there are situations that may compromise the treatment, the issue becomes more complex in patients with systemic diseases. In this way, nine of these diseases have been identified, detailing the reflections in the installation of implants. The literature recommends consistent anamnesis, evaluations by computed tomography, implant type selection, design and implant surface and systematic follow-up for the installation of implants in individuals with systemic changes. There are currently 1,300 different implant systems, which vary in shape, size, volume and surface material, body design, implant-abutment connection, topography and surface chemistry and wettability, some indicated for bone tissue compromised in quality and quantity. It is the professional responsibility be secure in his clinical knowledge for the success of therapy and evaluate them in order to achieve a good planning and operation. Keywords: Bone quality. Bone quantity. Bone density. Committed bone. Changes in bone metabolism. Implants.