Comportamento biomecânico de implantes extra-estreitos

Abstract

The evolution of implant dentistry has enabled significant advances in the treatment of patients with tooth loss, initially focused on cases of total edentulism. Over time, clinical indications expanded, requiring adaptations to implants, especially regarding their diameter. This led to the emergence of narrow implants and, later, extra-narrow implants, developed to treat regions with severe bone or spatial limitations, such as the anterior areas of the maxilla and mandible, as well as atrophic maxillae. These implants offer a less invasive alternative to bone grafts, especially in patients with contraindications to regenerative procedures, providing rehabilitation with shorter treatment times and lower morbidity. Despite the observed clinical benefits, extra-narrow implants still generate debate regarding their mechanical resistance, especially in areas with high functional demands. Modifications to implant design and the metal alloys used have sought to overcome this limitation. Clinical studies have demonstrated promising results, particularly in overdentures supported by two implants, promoting improvements in masticatory function and quality of life for edentulous patients. However, further long-term studies are needed to consolidate their indication in different types of rehabilitation, especially in posterior regions of the arch. This thesis aims to analyze the mechanical and clinical laboratory behavior of extra-narrow implants with a diameter of 2.9 mm, the Helix GM Narrow® model (Neodent®, Curitiba, PR, Brazil), as well as a systematic review of the survival of reduced-diameter implants. It is written in three chapters, the first being entitled "Influence of the prosthetic interface and the manufacturing metal on the mechanical behavior of two extra-narrow dental implants – In vitro study." The second is entitled "Clinical results of single narrow-diameter implants in areas of low masticatory load: a systematic review." The third is entitled "Survival of extra-narrow implants in aesthetic regions: A clinical study with 12 months of follow-up." In this study, the reduced-diameter implants demonstrated satisfactory performance, both clinically and in laboratory tests.