AVALIAÇÃO DE TERAPIAS COMBINADAS NO TRATAMENTO CIRÚRGICO DA PERI-IMPLANTITE: UMA REVISÃO INTEGRATIVA
DOI:
https://doi.org/10.24980/ucm.v13i15.6244Palavras-chave:
Peri-implantite, Periodontia, Implante dentário osseointegradoResumo
A peri-implantite é um processo inflamatório que afeta os tecidos ao redor de implantes funcionais osseointegrados, promovendo a perda progressiva do osso de suporte. Essa revisão integrativa da literatura teve como objetivo avaliar os resultados de diferentes terapias combinadas com técnicas cirúrgicas para o tratamento da peri-implantite. Foi realizada uma pesquisa da literatura nos bancos de dados PubMed e LILACS com os descritores peri-implantite e tratamento cirúrgico. Os critérios de seleção incluíram ensaios clínicos controlados e randomizados publicados nos últimos cinco anos, em inglês, com texto completo, nos quais as técnicas cirúrgicas tratavam a peri-implantite. Doze estudos atenderam aos critérios de inclusão e foram submetidos à análise. Quatrocentos e sessenta e cinco pacientes foram avaliados, em um período aproximado de acompanhamento de 12 meses. As terapias combinadas com as técnicas cirúrgicas foram o uso de proteína derivada da matriz do esmalte (EMD), tratamento com antibióticos, terapia fotodinâmica antimicrobiana, implantoplastia, jateamento de glicina e enxertos ósseos, principalmente de origem aloplástica ou xenogênica, que foram associados ou não a membranas biorreabsorvíveis e ácido ortosilícico estabilizado em colina. Com base nos resultados, as terapias combinadas com enxertos ósseos foram mais empregadas, independentemente da origem. No entanto, o material de enxerto de origem xenógena apresentou melhores resultados na porcentagem de preenchimento do defeito ósseo. Além disso, o PDME também apresentou resultados positivos quando utilizado. De acordo com a questão-problema estabelecida, as terapias combinadas associadas às técnicas cirúrgicas são mais eficazes do que as terapias cirúrgicas isoladas, e o uso de materiais de enxerto ou o PDME apresentaram os melhores resultados.
EVALUATION OF COMBINED THERAPIES IN THE SURGICAL TREATMENT OF PERI-IMPLANTITIS: AN INTEGRATIVE REVIEW
Periimplantitis is an inflammatory process that affects the tissues around osseointegrated functional implants, promoting progressive loss of supporting bone. This integrative literature review aimed to evaluate the results of different therapies combined with surgical techniques for treating peri-implantitis. A literature search was performed in PubMed and LILACS databases with periimplantitis and surgical treatment descriptors. The selection criteria included randomized controlled clinical trials published in the last five years, in English, with full text, in which surgical techniques treated peri-implantitis. Twelve studies met the inclusion criteria and were submitted for analysis. Four hundred sixty-five patients were evaluated, with a mean follow-up period of 12 months. The therapies combined with surgical techniques were the use of enamel matrix-derived protein (EMD), antibiotic therapy, antimicrobial photodynamic therapy, implantoplasty, glycine blasting, and bone grafts, mainly of alloplastic or xenogeneic origin, which were associated or not with bioresorbable membranes and choline-stabilized orthosilicic acid. Based on the results, the combined therapies with bone grafts were more employed regardless of origin. However, the grafting material of xenogenous origin showed better results in the percentage of filling of the bone defect. Moreover, PDME also showed positive results when used. According to the established problem question, combined therapies associated with surgical techniques are more effective than isolated surgical therapies, and using grafting materials or the PDME presented the best results.
Keywords: peri-implantitis; periodontics; osseointegrated dental implantation.
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