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Integración de tejidos duros y blandos alrededor de implantes tipo Prama. estudio experimental in vivo-resultados histométricos

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2020
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Introducción: El implante Prama se ha postulado como una alternativa para conseguir mayor estabilidad de los tejidos periimplantarios a largo plazo por las características de su diseño. Sin embargo, hay una ausencia de estudios comparativos que comprueben su eficacia y demuestren su superioridad frente a los implantes convencionales. Objetivos: Realizar un análisis histométrico comparativo que muestre diferencias entre los implantes Prama (test) e implantes Premium One (control), con respecto a la posición, altura y grosor de los tejidos blandos peri-implantarios, a la posición del primer contacto hueso implante, y al grosor de la cresta ósea perimplantaria, a las 4 y a las 12 semanas de su colocación. Material y métodos: 8 perros Beagle han recibido 32 implantes (16 control y 16 test) con 2 tiempos de cicatrización distintos (4 semanas y 12 semanas) tras 8 semanas de la extracción de las raíces mesiales de 1M1 y 2P2. Los perros se sacrificaron 12 semanas después de la colocación de los primeros implantes para el análisis histológico de los tejidos periimplantares. Resultados: La posición del primer hueso en contacto con el implante fue más coronal en los implantes test respecto a los controles en los dos tiempos quirúrgicos (0,97mm a las 4 semanas p=0,37 y 0,82mm a las 12 semanas p=0,59). La posición del margen gingival libre respecto a la posición original del hueso fue más coronal en los implantes test comparado con los controles (1,09mm a las 4 semanas p=0,31 y 0,19 a las 12 semanas p=1,00). A las 4 semanas, la mucosa era más gruesa en el grupo de implantes Prama (0,43m a 1mm p=0,43; 0,46mm a 2mm p=0,96; 0,37mm a 3mm p=1,00) Conclusiones: Los implantes Prama tras la cicatrización presentan el primer hueso en contacto con el implante y el margen gingival libre en una posición más coronal que los implantes control. El grosor de la mucosa a las 4 semanas fue mayor en el grupo test. Se necesitan más ensayos clínicos para conocer el comportamiento de los tejidos periimplantarios alrededor de estos implantes
Introduction: The Prama implant is a new implant design which aims to provide more stability of the peri-implant tissues through a specific morphology of the implant neck and prosthetic connection. However, there is a lack of comparative studies addressing its superiority and inquiring regarding the development of the peri-implant soft tissue seal. Objectives: The aim of this study is to perform an histometric analysis comparing the Prama implant (Test) and the Premium One Implant (Control) with respect to the height and thickness of the peri-implant tissues, the position of the peri-implant bone, and the one of the free gingival margin at 4 and 12 weeks. Material and methods: 32 implants have been placed in 8 beagle dogs (16 control and 16 test) with 2 different healing times (4 weeks and 12 weeks) 8 weeks after the extraction of the mesial roots of M1 and P2. The dogs were sacrificed 12 weeks after placing the first implants in order to analyze histologically the peri-implant tissues. Results: The position of the first bone to implant contact in the test implants was more coronal than in the control implants in both of the surgical times (0,97mm at 4 weeks and 0,82mm at 12 weeks). The position of the free gingival margin with respect to the original position of the bone was more coronal in the test implants compared to the controls (1.09mm at 4 weeks p = 0.31 and 0.19mm at 12 weeks p = 1.00). At 4 weeks, the width of the mucosa was greater in the Prama group (0,43m at 1mm p=0,43; 0,46mm at 2mm p=0,96; 0,37mm at 3mm p=1,00) Conclusions: After healing, Prama implants present the first bone to implant contact and the free gingival margin in a more coronal position than control implants. The width of the mucosa at 4 weeks is greater in Prama implants. More clinical trials are needed to know the behavior of the peri-implant tissues around these implants
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Trabajo Fin de Master encuadrado en la línea de investigación Eficacia de los protocolos quirúrgicos y regenerativos en implantología
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