Avaliação comparativa entre as técnicas All-on-four e Four-onpillars em planejamentos virtuais 3D associadas a cirurgias guiadas em maxilas atróficas
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Data
2021
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Universidade Brasil
Resumo
Thorough technical knowledge and anatomical understanding are critical for optimal
surgical results. The difficulty of complete maxillary surgery can vary significantly
depending on the complexity of the anatomy or bone defect. Guided surgery is
currently a relevant option for bringing to the patient fewer surgical complications and
is directly related to 3D virtual planning for the success of the case. In this work, we
analyze and compare two methods of planning guided in software for the manipulation
of dental implants, associated with the All-on-four (A.F.) and Four-on-pillars (F.P.)
techniques used in patients with atrophic maxillae. Forty-two images of totally
edentulous patients were analyzed, 30 of which were planned using ImplantViewer
software for volume assessment and ImageJ software for area assessment. The
volumes were acquired in a CRANEX 3D volumetric tomograph model from the
Soredex brand. In each planning, the height and width of the bone remnant was used
as guidance and the implants were installed virtually. The average area of the Fouron-pillars technique was 4.9x (p<0.0001) greater than the average area with the Allon-four technique, this represents a difference of 489%, which in the same force
applied by the jaw we have a 4.9x lower pressure, that is, a better distribution of forces
on the jaws. It was not possible to notice a statistical difference between the success
proportions (p=0.2542), showing that the techniques have a non-different (similar)
success proportion. We conclude that the area formed in the Four-on-pillars surgical
planning is larger than in the All-on-four planning and also that there is no technique
with successful advantages over another, therefore the Four-on-pillars technique
becomes an excellent option as a treatment for atrophic jaws.
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Bioengenharia, Odontologia, Maxila, Implante dentário