Publication
Alterações no contato interproximal entre dente natural e prótese implanto-suportada: revisão sistemática e meta-análise
| Name: | Description: | Size: | Format: | |
|---|---|---|---|---|
| Projeto de pós-graduação_2022100344 | 1.42 MB | Adobe PDF |
Authors
Advisor(s)
Abstract(s)
Objetivo: Avaliar a ocorrência da perda de contato proximal (ICL) entre dente natural e prótese sobre implante, quanto à localização, tipo e quantidade de retenção e possíveis alterações clínicas que possam ocorrer na região periodontal e/ou periimplantar ou no conforto geral do doente.
Metodologia: Revisão sistemática da literatura baseada na estratégia de pesquisa PICO, seguindo o preconizado na metodologia PRISMA. O estudo foi registado na plataforma PROSPERO com o código identificador CRD42023446235. Foi efetuada uma pesquisa nas bases de dados PubMed, B-on, Google Scholar e Web of Science, sem determinação do limite temporal de publicação e utilizando os MesH Terms "(implante dentário ou prótese suportada por implante)" e "(perda de contato proximal ou perda de contato interproximal ou contato aberto ou adjacente dente natural)" e "(impactação alimentar)".
Resultados: Das 2101 publicações encontradas que, após as exclusões, de acordo com a metodologia aplicada um total de 41 artigos foram selecionados e destes 19 artigos foram elegíveis para meta-análise (13 ensaios retrospetivos e 6 prospetivos). Avaliaram-se um total de 2047 pacientes e 7319 próteses em função, verificou-se a perda de contato proximal em 51% com intervalo de confiança 0,40 a 0,61 com p<0,01. Na deteção da ICL o fio dentário foi utilizado em 65%, as matrizes interproximais em 30% e técnicas radiográficas em 5%. O follow-up das publicações variou de 1 a 21 anos, sendo 50% das publicações entre 1 a 3 anos, 25% de 3 a 10 anos e 25% entre 10 e 21 anos. Observou-se que a ICL ocorria com maior frequência na mandíbula. Não foi constatada diferença estatística significativa entre as regiões anterior (55%) e posterior (47%). Na face mesial, a ICL variou entre 13% a 81,4%, possivelmente devido aos diferentes períodos de follow-up e à diversidade de métodos aplicados na avaliação. Não se detetaram diferenças entre as próteses unitárias com 50% (0,38 a 0,62) ou múltiplas com 52% (0,35 a 0,69). Várias publicações não fizeram menção qual o tipo de retenção aplicada.
Conclusão: A impactação alimentar é a consequência mais comum da ICL, sendo mais prevalente na face mesial da prótese implanto-suportada na região posterior da mandíbula. Há evidência de mucosite periimplantar, porém sem evolução para periimplantite, não sendo relevante a forma de retenção ou o número de elementos da prótese. Salienta-se a importância da avaliação do esquema oclusal. A colocação de uma goteira de contenção não foi conclusiva para evitar a ICL.
Objective: To evaluate the occurrence of proximal contact loss (ICL) between natural teeth and implant-supported prostheses, in terms of location, type and amount of retention and possible clinical alterations it may cause in the periodontal or peri-implant region or in the patient's general comfort. Methodology: Systematic literature review based on the PICO search strategy, following the PRISMA methodology. The study was registered on the PROSPERO platform with the identifier code CRD42023446235. A search was carried out in the PubMed, B-on, Google Scholar and Web of Science databases, without setting a time limit for publication and using the MesH Terms "(dental implant or implant-supported prosthesis)" and "(loss of proximal contact or loss of interproximal contact or open contact or adjacent to natural tooth)" and "(food impaction)". Results: Of the 2047 publications found that after exclusions according to the methodology applied a total of 41 articles were selected and of these 19 articles were eligible for meta-analysis (13 retrospective and 6 prospective trials). A total of 2047 patients and 7,319 prostheses in function were evaluated, and loss of proximal contact was found in 51% with a confidence interval of 0.40 to 0.61 with p<0.01. To detect ICL, dental floss was used in 65% of cases, matrices in 30% and X-rays in 5%. The follow-up of the publications ranged from 1 to 21 years, with 50% between 1 and 3 years, 25% between 3 and 10 years and 25% between 10 and 21 years. ICL was found to occur more frequently in the mandible. There was no statistically significant difference between the anterior (55%) and posterior (47%) regions. On the mesial face, the ICL ranged from 13% to 81.4%, possibly due to the different follow-up periods and the diversity of methods used in the assessment. No differences were found between single prostheses with 50% (0.38 to 0.62) or multiple prostheses with 52% (0.35 to 0.69). Several publications made no mention of the type of retention applied. Conclusion: Food impaction is the most common consequence of ICL and is more prevalent on the mesial side of implant-supported prostheses in the posterior mandible. There is evidence of perimplant mucositis, but without progression to perimplantitis, and the form of retention or the number of prothesis elements is not relevant. The importance of assessing the occlusal scheme is highlighted. The placement of a retaining drip was not conclusive in preventing ICL.
Objective: To evaluate the occurrence of proximal contact loss (ICL) between natural teeth and implant-supported prostheses, in terms of location, type and amount of retention and possible clinical alterations it may cause in the periodontal or peri-implant region or in the patient's general comfort. Methodology: Systematic literature review based on the PICO search strategy, following the PRISMA methodology. The study was registered on the PROSPERO platform with the identifier code CRD42023446235. A search was carried out in the PubMed, B-on, Google Scholar and Web of Science databases, without setting a time limit for publication and using the MesH Terms "(dental implant or implant-supported prosthesis)" and "(loss of proximal contact or loss of interproximal contact or open contact or adjacent to natural tooth)" and "(food impaction)". Results: Of the 2047 publications found that after exclusions according to the methodology applied a total of 41 articles were selected and of these 19 articles were eligible for meta-analysis (13 retrospective and 6 prospective trials). A total of 2047 patients and 7,319 prostheses in function were evaluated, and loss of proximal contact was found in 51% with a confidence interval of 0.40 to 0.61 with p<0.01. To detect ICL, dental floss was used in 65% of cases, matrices in 30% and X-rays in 5%. The follow-up of the publications ranged from 1 to 21 years, with 50% between 1 and 3 years, 25% between 3 and 10 years and 25% between 10 and 21 years. ICL was found to occur more frequently in the mandible. There was no statistically significant difference between the anterior (55%) and posterior (47%) regions. On the mesial face, the ICL ranged from 13% to 81.4%, possibly due to the different follow-up periods and the diversity of methods used in the assessment. No differences were found between single prostheses with 50% (0.38 to 0.62) or multiple prostheses with 52% (0.35 to 0.69). Several publications made no mention of the type of retention applied. Conclusion: Food impaction is the most common consequence of ICL and is more prevalent on the mesial side of implant-supported prostheses in the posterior mandible. There is evidence of perimplant mucositis, but without progression to perimplantitis, and the form of retention or the number of prothesis elements is not relevant. The importance of assessing the occlusal scheme is highlighted. The placement of a retaining drip was not conclusive in preventing ICL.
Description
Keywords
Perda de contato interproximal Implante dentário Dente adjacente Impactação alimentar Prótese implantossuportada Loss of interproximal contact Dental implant Adjacent tooth Food impaction Implant-supported prosthesis