Publication: Cambios en los tejidos blandos y duros tras la reconstrucción de la cresta ósea y tras el uso de implantes dentales con diferente geometría
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2018-10-22
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Universidad Complutense de Madrid
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Abstract
Antecedentes: La reabsorción de la cresta ósea después de la extracción dentaria provoca un colapso del reborde alveolar, que dependiendo de su grado, puede conllevar la necesidad de procedimientos regenerativos o del uso de implantes de diámetro reducido o diseño cervical modificado. Actualmente, el éxito en las restauraciones sobre implantes no se mide únicamente por la supervivencia del implante y la ausencia de complicaciones, sino también por la integración con los tejidos adyacentes. En este contexto, el tejido blando peri-implantario es de vital importancia en la consecución de resultados predecibles a largo plazo. A pesar de su contrastada importancia, el conocimiento de su comportamiento y cicatrización, el impacto del enfoque quirúrgico (inmediato o diferido) así como su interacción con el tejido óseo es exiguo. Estas limitaciones derivan, fundamentalmente, de las carencias inherentes a la metodología utilizada hasta la fecha. Objetivos: Los objetivos de esta serie de trabajos han sido i) analizar la integración y comportamiento del tejido duro y blando al usar implantes con un diseño cervical triangular comparados con implantes cilíndricos convencionales colocados en crestas cicatrizadas y alveolos post-extracción (Estudio 1), ii) estudiar la diferencia relativa en el volumen de tejido blando y duro aplicando una metodología novedosa basada en la superposición de imágenes de Micro CT y STL (Estudio II) y iii) Estudiar el comportamiento del tejido blando en procedimientos de regeneración ósea horizontal mediante el uso de sustitutos de tejido óseo y membranas reabsorbibles (Estudio III)...
Introduction: The physiologic changes that occur after tooth extraction may originate alveolar ridge deformities. Depending on the degree of resorption these defects may need hard tissue reconstruction procedures or the use of implants with a reduced diameter or a modified cervical design. The success of implant supported restoration and implant therapy is not based anymore solely on the survival of the implant but also on the integration of the restoration with the surrounding tissues. In this context, peri-implant soft tissue plays a critical role in the esthetic appearance of the reconstructions. Despite of its crucial importance the current knowledge of its clinical behavior, the impact of the surgical approach and the mutual interplay that soft and hard tissue have is scarce are poorly understood. These limitations are mainly originated by the inherent restrictions of the avaialble methodological techniques employed to evaluate them. Objectives: The main objective of these series of investigations were i) to analyze the soft and hard tissue integration when using implants with a triangular cervical design and implants with a conventional cylindrical design placed in healed sites or in postextraction sockets (Study 1), ii) to analyze the relative differences in soft and hard tissue volume utilizing a novel imaging methodology (Study 2) and iii) to study the soft tissue contour changes in lateral ridge augmentation procedures when employing three different treatment alternatives based on the use of xenograft bone substitutes, collagen membranes or the combination of the two (Study 3)...
Introduction: The physiologic changes that occur after tooth extraction may originate alveolar ridge deformities. Depending on the degree of resorption these defects may need hard tissue reconstruction procedures or the use of implants with a reduced diameter or a modified cervical design. The success of implant supported restoration and implant therapy is not based anymore solely on the survival of the implant but also on the integration of the restoration with the surrounding tissues. In this context, peri-implant soft tissue plays a critical role in the esthetic appearance of the reconstructions. Despite of its crucial importance the current knowledge of its clinical behavior, the impact of the surgical approach and the mutual interplay that soft and hard tissue have is scarce are poorly understood. These limitations are mainly originated by the inherent restrictions of the avaialble methodological techniques employed to evaluate them. Objectives: The main objective of these series of investigations were i) to analyze the soft and hard tissue integration when using implants with a triangular cervical design and implants with a conventional cylindrical design placed in healed sites or in postextraction sockets (Study 1), ii) to analyze the relative differences in soft and hard tissue volume utilizing a novel imaging methodology (Study 2) and iii) to study the soft tissue contour changes in lateral ridge augmentation procedures when employing three different treatment alternatives based on the use of xenograft bone substitutes, collagen membranes or the combination of the two (Study 3)...
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Tesis inédita de la Universidad Complutense de Madrid de la Facultad de Odontología del Departamento de Estomatología III, leída el 29 de Junio de 2017.