Avaliação clínica de prótese total fixa implantossuportada de resina acrílica desprovida de infra-estrutura metálica com carga imediata: controle de 2 anos

Abstract

The aim of the present study was to present a 2-year follow-up of clinical evaluation of a mandibular implant supported rehabilitation technique free of metallic framework, used as immediate load system. Fourteen totally edentulous patients were selected, who were treated with five fixtures installed in the anterior mandible between the mental foramens, height ranging from 10 to 18mm, and 3.75 and 4.0mm in diameter. Over the implants, a fixed prosthesis was immediately prepared, free of metallic framework using the conventional prosthesis of the patient and specific prosthetic components. This immediate load system was evaluated in 4-month, 1 and 2-year follow-ups, after the surgical procedure. The criteria used for the evaluation were clinical and radiographic examinations, which included stability analysis of the implants by means of resonance frequency analysis. As results, clinical success was achieved with no implant loss and the maintenance of all prosthesis, with adequate functional conditions. The resonance frequency analysis showed high levels of primary stability, which indicated a favorable condition to osseointegration. Comparisons among the obtained values in the follow-up period presented a reduction in implant stability at the moment of the installation (ISQ1 mean 73.59 ± 5.31) until the end of the fourth month (ISQ2 mean 71.66 ± 5.06) followed by a recovery at the end of the first year (ISQ3 mean 73.00 ± 4.64) and stabilization during the second year of function (ISQ4 72.99 ± 5.10). Radiographically, a tendency for the maintenance of bone architecture around the implants was observed. In this way, it can be concluded that the evaluated prosthetic rehabilitation system offered conditions for the osseointegration of the implants in mandibular protocols, and did not negatively interfered in the maintenance of the implant stability during the evaluated periods. This technique represents a viable alternative for the clinician, offering esthetic and functional results similar to those achieved with the conventional techniques plus the advantage of the simplification of the procedures and reduced cost. Rigid follow-up of the cases must be considered for the indication of the presented technique as a definite treatment.