Efeito de diferentes macroestruturas e microestruturas sobre a estabilidade primária e secundária de implantes dentários

Abstract

Primary and secondary stability are important pillars for the evolution of the osseointegration process and for achieving successful in the implant rehabilitation. Several factors can influence the achievement of this primary and secondary stability. Improvements in the micro and macrostructure of implants directly influence the achievement of a good primary and secondary stability. However, there is still a lot of divergence in the literature about which factors exert more clinical influence on the implant’s stability. Therefore, it is still necessary to evaluate the influence of macrostructure and microstructure in the process of obtaining primary and secondary stability. Thus, this thesis aimed, through clinical studies and a systematic literature review, to evaluate the effect of a hydrophilic implant surface and a hybrid implant macrostructure (cylindrical-conical with heterogeneous thread profile) on the primary and secondary stability of the implants. The thesis was divided into 3 chapters according to the specific objective that generated the 3 studies in this manuscript. Objective Specific 1: Primary and secondary stability of implants with hydrophilic surface in posterior maxilla: Split-mouth randomized clinical trial. In this study, 2 types of implant microstructure with the same macrostructure in the posterior maxilla were evaluated. Specific objective 2: Is there a difference between primary and secondary stability and survival rate in hydrophilic compared to non-hydrophilic implants? Systematic review meta-analysis. This study analyzed existing clinical articles comparing the results of primary and secondary stability and survival rate. Specific objective 3: Primary and secondary stability of hybrid implants with different thread configurations. Controlled and randomized clinical study in a split-mouth model. This study was an analysis of implants with different macrostructure, a conical compared to a hybrid, with the same microstructure in the maxilla. After analyzing the results of these studies, it can be concluded that the macrostructure had a greater clinical influence on primary and secondary stability compared to the microstructure. Pre-existing clinical studies showed no statistical difference between hydrophilic implants of the same macrostructure compared to non-hydrophilic ones. Regarding the survival rate, there was no difference when comparing studies with a hydrophilic surface compared to a non-hydrophilic one. Implants with a hydrophilic surface, but with different macrostructural characteristics showed different stability during the osseointegration process. It is necessary to carry out studies related to microstructures, under conditions in which they can exert a significant improvement, such as complicating factors, patients with bone metabolism diseases, smokers, diabetics, among others. Keywords: Implant surfaces, macrostructure, osseointegration, stability,