A importância da prótese provisória, no manejo dos tecidos moles periimplantares em região estética

Abstract

Resumo: Implants in aesthetic regions present a great challenge to professionals, who need to be careful. not only the drilling technique, but also the physiology and integrity of the peri- implant tissues. Therefore, the importance of using a temporary prosthesis during the period of osseointegration and healing of soft tissues is observed. Previously, only temporary mobile or fixed adhesive prostheses were used to meet aesthetic needs, however such prostheses, in addition to some discomfort, presented aesthetic limitations and greater discomfort for the patient. Currently, immediate provisionalizations are carried out on implants, with the aim of preserving the gingival contours, providing preservation, or conditioning of the gingival profile, which will be "copied" to create the definitive prosthesis. The objective of this work was to carry out a literature review, searching the pubmed and schoolar google platforms for articles published between 2013 and 2023, and verify the importance of using immediate provisionalization for aesthetics and maintenance of gingival tissues. In this review it was observed that the procedure has the following main advantages: reduction of treatment time, improvement of the aesthetic result in relation to soft tissues as they provide better accommodation of the same, maintenance of their shape and the possibility of carrying out guided healing of the tissues. adjacent moles by manipulating the shape of the provisional. However, to make this technique viable, a minimally invasive extraction is necessary with the aim of preserving the alveolus, mainly the vestibular bone plate; as well as preserving the adjacent soft tissues and filling the vestibular gap, due to the more palatalized positioning of the implants. In the case of immediate provisionalization on a late- installed implant, the ideal is to preserve as much soft tissue as possible using a crestal incision only or a peri-implant plastic surgery technique that aims to improve the tissue around the prostheses. Thus, it is concluded that immediate provisionalization is important to maintain or guide the healing of peri-implant soft tissues (From the title of the work, it is understood that the implants are osseointegrated or have had an adequate touch during installation).

Abstract: Oral rehabilitation with osseointegrated implants is considered the gold standard in contemporary dentistry, offering advantages such as retention, chewing function, functionality, and aesthetics, as well as increased durability. However, early peri-implant bone loss can lead to treatment failure. Studies have associated this bone loss with increased failure rates. The platform switching technique, which utilizes a smaller-diameter abutment compared to the implant platform, has been studied to maintain peri-implant tissues. However, the number of clinical studies investigating the effects of this technique is limited. Therefore, this study aims to review the literature on clinical studies that address the influence of platform switching on peri-implant tissues, as well as its clinical and functional effects in the medium and long term. Platform switching has been increasingly adopted in implant dentistry due to its potential benefits for peri-implant health, such as preservation of marginal bone, stability of soft tissues, and reduction of peri-implant bone loss. However, more longitudinal research is needed to provide more conclusive evidence regarding the effectiveness and limitations of platform switching in different clinical scenarios.Abstract: