Impacto de overdentures mandibulares retidas por 2 e 3 implantes na remodelação óssea dos maxilares e na saúde peri-implantar: estudo comparativo

Abstract

This comparative study aimed to radiographically evaluate maxillary and mandibular bone remodeling and peri-implant health parameters in patients rehabilitated with Total Maxillary Prosthesis (PTM) and Mandibular Overdenture (OM) retained by 2 or 3 implants, after 1 year in function. A total of 31 patients, divided into two groups, retained by 2 implants (n=14) and 3 implants (n=17) were evaluated by means of linearly measured panoramic radiographs, at the installation of the OM (T0) and after 1 year ( T1). The anterior and posterior bone area and height of the mandible and maxilla were evaluated, and peri-implant bone loss variations radiographically analyzed, in addition to peri-implant health indicators: The plaque index (IP); the presence of calculus (PC), degree of peri implant inflammation (GIP), probing depth (PS) and bleeding index on probing (ISG) were evaluated. Data were analyzed for normality using the Shapiro-Wilk test. Differences between T0 data and T1 year data within groups were analyzed using the Wilcoxon test. The correlation between the two groups, for peri-implant health levels, was verified using the Spearman Correlation. For peri-implant health monitoring, marginal bone loss and changes in peri-implant bone level were determined by panoramic radiography and the differences between periods t0 and t1 were analyzed using the paired Student's t test. For all tests, the significance level of 5% was adopted. Results: No statistically significant difference in maxillary and mandibular bone remodeling was observed when comparing areas between groups of 2 and 3 implants. When evaluating the right and left sides at the points (L1, L2, L3, R1, R2, R3) in the mandible, a statistically significant difference was observed in the L1 region (p<0.043). In the correlation between the variables related to peri-implant health of 2 and 3 implants, significant values were found for 2 implants: IPS V and GIP (p<0.024), ISG D and GIP (p<0.021) and for 3 implants: for IP and ISG M (p<0.030), ISG D and GIP (p<0.021). In monitoring the distal and mesial peri-implant bone level between both groups, no statistically significant difference was found. Conclusions: the treatment of completely edentulous patients with OM retained by 2 and 3 implants showed stable bone remodeling in the maxilla and mandible after 1 year of function. Likewise, peri-implant health levels were similar in both groups. Both treatments are safe options in rehabilitation with mandibular overdentures, capable of protecting the residual ridge adjacent to the prostheses where the number of implants was not able to influence the peri-implant bone condition, posterior region of the mandible and maxilla in 1 year after installation. of the implants.