Publication: Remodelación de los tejidos blandos alrededor de implantes inmediatos y diferidos.Estudio experimental en perros Beagle.
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2017
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Vignoletti, Fabio
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Abstract
Antecedentes: Los protocolos de implantes inmediatos (tipo 1) y diferidos (tipo 2) son considerados unánimemente como las dos alternativas principales para el reemplazo de un diente desahuciado. Sin embargo, todavía falta una comparación directa de los dos, sobre la organización de los tejidos perimplantarios, tanto duros como blandos.
Objetivos: Investigar la presencia de diferencias significativas en la altura y el grosor del tejido blando alrededor de implantes inmediatos y precoces en fases de cicatrización temprana y tardía.
Métodos: 8 perros de raza Beagle han recibido 32 implantes inmediatos (test) y 32 implantes diferidos (control). Los implantes inmediatos fueron puestos en los alvéolos mésiales de 3P3 y 4P4, mientras los diferidos fueron puestos en los alveolos mésialed de 1P1 y 2P2, 8 semanas después de la emi-sección de los dientes y la extracción de las raíces mésiales. Los implantes diferidos Los perros fueron sometidos a eutanasia después 2 y 8 semanas para el análisis histológico. Mitad de los sitios implantares fueron procesados con técnica calcificada y la otra mitad con técnica descalcificada.
Resultados: En las secciones descalcificadas, la anchura biológica perimplantaria fue significativamente mayor a las 2 semanas (I-J = 1,5 mm; p = 0,028) y casi significativamente mayor a las 8 semanas (I-J = 1 mm; p = 0,088). Sin embargo, no se observaron diferencias significativas en las secciones calcificadas. Con respecto al grosor del tejido, se observaron valores consistentemente más altos en el grupo control a las 2 semanas (de 0,69 a 1,51 mm), pero esta diferencia se redujo abundantemente a las 8 semanas (0,2 a 0,6 mm) y casi siempre perdió significación estadística.
Conclusiones: A las 8 semanas de cicatrización, la formación de la mucosa perimplantaria alrededor de implantes inmediatos y diferidos fue asociada a ninguna diferencia relevante en el espesor del tejido blando. En las secciones descalcificadas, se observó una anchura biológica approx. mayor de 1 mm en los implantes inmediatos. Dicha diferencia implicaba tanto el epitelio de unión como el tejido conectivo de aprox. 0,5 mm cada uno.
Background: The immediate (type 1) and delayed (type 2) implant protocols are unanimously considered as the two main alternatives for the replacement of a hopeless tooth. However, a direct comparison investigating the biological implications of these two alternatives, both at the hard and soft tissues level, is still lacking. Objective: To inquire whether significant differences in biologic width and soft tissues thickness can be detected among immediate and early implants at early and late stages of healing. Methods: 8 beagle dogs received 32 immediate (test) and 32 early (control) implants. Immediate implants were placed at the mesial socket of 3P3 and 4P4 whereas Delayed implants were placed 8 weeks after teeth emi-section and extraction of either 2P2 and 1M1,. The implant platform was placed at the level of the marginal buccal bone crest. Animals were sacrificed at 2 and 8 weeks for histological examination. Half of the implant sites were processed for ground sectioning and the other half for decalcified sectioning in paraffin. Results: In the decalcified sections, the peri-implant biologic width was significantly higher at 2 weeks (I-J = 1,5mm; p= 0,028) and almost significantly higher at 8 weeks (I-J = 1mm; p = 0.088). However, no significant differences were observed in the ground sections. With respect to tissue thickness, consistently higher values were observed in the control group at 2 weeks (from 0.69 to 1.51mm). However, this difference was abundantly reduced at 8 weeks (0.2 to 0.6 mm) and resulted to be non significant at most reference points. Conclusions: Results from this study suggest that, at 8 weeks of healing, the dimensions of the perimplant mucosa around immediate and delayed implants is associated with no relevant differences in soft tissue thickness. An approx. 1mm larger biological width was associated with in immediate implants in decalcified sections. Such difference involved both the junctional epithelium and the connective tissue for approx. 0.5mm each.
Background: The immediate (type 1) and delayed (type 2) implant protocols are unanimously considered as the two main alternatives for the replacement of a hopeless tooth. However, a direct comparison investigating the biological implications of these two alternatives, both at the hard and soft tissues level, is still lacking. Objective: To inquire whether significant differences in biologic width and soft tissues thickness can be detected among immediate and early implants at early and late stages of healing. Methods: 8 beagle dogs received 32 immediate (test) and 32 early (control) implants. Immediate implants were placed at the mesial socket of 3P3 and 4P4 whereas Delayed implants were placed 8 weeks after teeth emi-section and extraction of either 2P2 and 1M1,. The implant platform was placed at the level of the marginal buccal bone crest. Animals were sacrificed at 2 and 8 weeks for histological examination. Half of the implant sites were processed for ground sectioning and the other half for decalcified sectioning in paraffin. Results: In the decalcified sections, the peri-implant biologic width was significantly higher at 2 weeks (I-J = 1,5mm; p= 0,028) and almost significantly higher at 8 weeks (I-J = 1mm; p = 0.088). However, no significant differences were observed in the ground sections. With respect to tissue thickness, consistently higher values were observed in the control group at 2 weeks (from 0.69 to 1.51mm). However, this difference was abundantly reduced at 8 weeks (0.2 to 0.6 mm) and resulted to be non significant at most reference points. Conclusions: Results from this study suggest that, at 8 weeks of healing, the dimensions of the perimplant mucosa around immediate and delayed implants is associated with no relevant differences in soft tissue thickness. An approx. 1mm larger biological width was associated with in immediate implants in decalcified sections. Such difference involved both the junctional epithelium and the connective tissue for approx. 0.5mm each.
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