Resultados comparativos da utilização de pilares de cicatrização customizados em implantes imediatos pós extração maxilares

Description

Introduction: After a single-tooth extraction, physiological remodeling processes are unavoidable which leads to a total loss of the periodontal ligament and resorption of the bundle bone. Immediate implant placement (IIP) associated with the use of bone substitutes and collagen matrices seems to reduce the amount of resorption at periimplant areas. Recently, customized healing abutments appeared as another solution to seal the socket and preserve the original soft tissue contour. The aim of this study is to compare the clinical differences reported during the first year of treatment between two types of alveolar sealing, when used with immediate implants in the aesthetic area. Materials and Methods: The present study was designed as a prospective, randomized, controlled clinical trial with a parallel-group design. Patients treated with single-tooth maxillary implants after atraumatic flapless extraction, between 15 and 25, were allocated into two groups regarding a different type of socket sealing: Group I received a collagen matrix and group II was treated with a customized healing abutment. Digital impressions were taken prior to extraction (T0), one month (T1), four months (T2) and 12 months (T3) after implant insertion. The digital files were superimposed with computer software allowing to evaluate volumetric changes between different time points at peri-implant tissue areas like Buccal Volume Variation (BVv) and Total Volume Variation (TVv). Mucosa variation between T0 and T3 was digitally computed assessing the papilla presence at mesial (MPHv) and distal (DPHv) sites and the mucosa height (MGHv). Mean values were compared and statistical significance was set at 0,05. Results: Twenty-eight patients (mean age 54,00+/-12,20 years), fourteen in each group, were evaluated after a 12-month period. No complications occurred in all included patients during the follow-up periods. Significant differences between mean values of BVv at T1 (p=0,043) were observed at the Group I and Group II (-9,75+/-6,65% and -4,76+/-5,29%, respectively). Also, during the first month of treatment, TVv appeared as statistically significant (p=0,021) showing a variation of -8,90+/-5,03% at Group I and -4,17+/-4,52% at Group II. At one-year follow-up, no significant differences were found in terms of volume variation between the two groups. Regarding mucosa variation, only mean values of MPHv exhibited significant differences (p=0,048), observing a variation of -0,47+/-0,38mm at Group I and -0,24+/-0,18mm at Group II. Conclusion: Both treatment modalities showed a predictable socket sealing option in maxillary immediate implant placement yet failed to prevent volume tissue loss on periimplant areas. At the first month of treatment, customized abutments presented less volume variation, although no differences could be assessed at the 1-year follow up.

Period	19 Aug 2020
Held at	Universidade Católica Portuguesa
Degree of Recognition	Master