Influência de parâmetros transcirúrgicos na seleção de componentes protéticos e perda óssea marginal após 12 meses de instalação de coroas unitárias: avaliação prospectiva clínica e radiográfica

Abstract

Implantology has demonstrated over the years as a treatment of choice to replace dental absences, restoring function and aesthetics with high success and survival rates, however, implants and restorations may have technical or biological complications in the development steps. The selection of the abutment is a critical step when performing prostheses retained by implants, the knowledge of these steps is important to identify potential intra-surgical and radiographic parameters that may be predictors in the selection of the height of the addendum. The prospective study was designed to assess the role of intra-surgical and radiographic measurements as predictors for selecting the height of the abutment and its influence on MBL (marginal bone loss) in single implants, according to the STROBE guidelines. In the implants placed immediately and late, the distances between the implant platform - alveolar bone crest, implant platform - gingival margin, and buccal gap (when present) were recorded using a straight periodontal probe. Digital radiographs were taken during implant placement (T0), selection of the height of the addition (Ta) and 1-year follow-up (Tf), and the distance between the implant platform and the alveolar bone crest was evaluated in millimeters. A total of 130 implants were placed in 68 patients. The mean intra-surgical distance between the bone crest and the implant platform was 1.71 mm (± 1.01) and the mean distance from the gingival margin to the implant platform was 3.94 mm (± 1.90), in the abutment selection, the transmucosal height mean was 3.58 mm (± 1.50); the correlation with the height of the selected abutment, the implant platform radiographically at a distance from the alveolar bone crest at T0 (r2 = 0.66; p-value <0.001) and transmucosal height at Ta (r2 = 0.81; p-value <0.001) showed a high linear correlation. The 1-year follow-up showed mean radiographic reduction of 0.95 mm between the implant platform and the alveolar bone crest; However, there was no correlation between MBL and abutment height (r2 = -0.09; p = 0.41). The knowledge of the steps of the intra-surgical and radiographic parameters can serve as a predictive factor to select the height of the abutment for definitive restorations.