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All-On-4: cirurgia convencional versus cirurgia guiada

Authors: Montalvão, Sílvia Gonzalez;

All-On-4: cirurgia convencional versus cirurgia guiada

Abstract

A técnica de All-on-4 é um método que utiliza a colocação de implantes com carga imediata, baseando-se no princípio de quatro implantes: dois anteriores na vertical e dois posteriores inclinados distalmente. Esta técnica pode ser realizada com recurso a cirurgia convencional ou a cirurgia guiada. A presente revisão sistemática integrativa teve como objetivo identificar as principais vantagens e desvantagens entre a cirurgia de All-on-4 convencional e a cirurgia guiada. Para tal foi realizada uma pesquisa com recurso ao motor de busca PubMed, num período compreendido entre 2011 e 2022. Após a seleção de 17 artigos, estes foram analisados de modo independente e realizou-se a extração de dados numa tabela resumo. Nos artigos selecionados foi comparada a taxa de sobrevivência dos implantes, a perda de osso marginal e as complicações biológicas para as técnicas de All-on-4 convencional e de cirurgia guiada. O número de implantes perdidos e a perda de osso marginal apresentaram valores superiores no primeiro ano após o procedimento, observando-se depois uma estabilização ou ausência de perda para ambas as técnicas. No entanto, as complicações biológicas apresentaram uma maior ocorrência na técnica de All-on-4 por cirurgia convencional, do que por cirurgia guiada. Deste modo, o procedimento da reabilitação por All-on-4 com cirurgia guiada parece aumentar o conforto do paciente no pós-operatório. No entanto, são necessários mais estudos que comparem as técnicas de All-on-4 convencional e a cirurgia guiada para aprofundar a avaliação do pós-operatório de ambas as técnicas.

All-on-4 is a method that uses the placement of implants with immediate loading, based on the principle of four implants: two vertically in the anterior region and two posteriorly inclined in the distal region. This technique can be performed using conventional surgery or guided surgery. The present systematic review aimed to identify the main advantages and disadvantages between All-on-4 with conventional surgery and All-on-4 with computer-guided surgery. For this, a search was carried out on PubMed, in a period between 2011 and 2022. After the selection of 17 articles, these were independently analyzed and data extracted was summarized in a table. In the selected articles, the implant survival rate, marginal bone loss and biological complications were compared between All-on-4 with conventional surgery and All-on-4 with computer-guided surgery. The number of lost implants and the marginal bone loss showed higher values in the first year after the procedure, which then stabilized. However, biological complications presented higher occurrence in the All-on-4 technique with conventional surgery compared to guided surgery. Thus, the All-on-4 rehabilitation procedure with guided surgery seems to increase postoperative patient comfort. However, further studies comparing both All-on-4 techniques are needed to better evaluate the postoperative period of both techniques.

Keywords

Dental Implants, Maxillary Edentulous, computer-guided surgery, Immediate Dental Implant Loading, All-on-4, All-on-four

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
0
Average
Average
Average
Green