Implantoprotetski radovi nošeni kratkim dentalnim implantatima

professional thesis

• Title (english): Implant-prosthetic rehabilitation using short dental implants
• Author: Sandra Kursar
• Mentor: Nikša Dulčić (mentor)
• Committee member: Darko Macan (predsjednik povjerenstva)
• Committee member: Nikša Dulčić (član povjerenstva)
• Committee member: Domagoj Žabarović (član povjerenstva)
• Granter: University of Zagreb; School of Dental Medicine; (Department of Removable Prosthodontics); Zagreb
• Defense date and country: 2019-07-18, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Dental Medicine; Prosthetic Dentistry

Abstract

Kratki dentalni implantati su povijesno povezani s nižim stopama preživljavanja i s nepredvidivim dugoročnim ishodima. Znanstveni dokazi ukazuju na to da kratki implantati (≤ 8 mm) imaju slične stope preživljavanja kao i implantati standardnih dimenzija (> 8 mm). Različiti oblici implantata, nadogradnji, vrsta veze i protetski nadomjesci bitni su čimbenici koji utječu na biomehaniku periimplantatnog tkiva, mikropropuštanje bakterija na razini implantat – nadogradnja te na preraspodjelu sila u kortikalnoj kosti oko implantata, što utječe na ukupni kumulativni uspjeh implantata. Svrha je rada razmotriti protetske čimbenike kojima se izbjegavaju biološke i mehaničke komplikacije. Pregledom literature prikazana su svojstva kratkih dentalnih implantata različitih proizvođača, stope uspješnosti uporabe kratkih implantata u različitim indikacijama, stope bioloških i tehničkih komplikacija povezanih s implantoprotetskim radovima nošenim kratkim implantatima i protetski čimbenici uspješne implantoprotetske rehabilitacije. Pregledom stručne i znanstvene literature putem PubMed mrežne stranice izvršena je meta-analiza. PubMed pretraživanje rezultiralo je pronalaskom 136 članaka, od kojih je, prema navedenim kriterijima uključivanja/isključivanja, 15 bilo dio meta-analize. Analizirano je ukupno 3336 ugrađenih kratkih dentalnih implantata duljine ≤ 8 mm i promjera ≥ 3 mm. Zaključak je da je visok kumulativni uspjeh kratkih dentalnih implantata moguć ako se poštuju protetski kriteriji uspješnosti: ugradnja kratkih dentalnih implantata u kost veće gustoće, pozicioniranje implantata u smjeru koji omogućuje aksijalni prijenos sila, uporaba implantata hrapave površine, većeg promjera sa što većim brojem navoja, postizanje koncepta implantat-zaštićene okluzije (implant-protected occlusion, IPO), uklanjanje lateralnih sila na protetskim nadomjescima, izbacivanje distalnih privjesaka na fiksnim protetskim konstrukcijama, splintiranje implantata te uporaba relaksacijskih Michigan udlaga u slučaju bruksizma.

Abstract (english)

Short dental implants are historically associated with lower survival rates and with unpredictable long-term outcomes. Scientific evidence suggests that short implants (≤ 8 mm) have similar survival rates as standard sized implants (> 8 mm). Different forms of implants, abutments, connection types, and prosthetic restorations are important factors that influence the biomechanics of the peri-implant tissue, bacterial microleakage at the implant – abutment level, and stress distribution in the cortical bone around implants, which influence the overall cumulative success of implants. The purpose of this paper is to establish prosthetic factors that help avoid biological and mechanical complications. Properties of short dental implants of different manufacturers, success rates of the use of short implants for various indications, biological and technical complications rates associated with prosthetic restorations supported by short implants, and prosthetic factors of successful implant-prosthetic rehabilitation, are shown in the literature review. A meta-analysis was performed by reviewing the professional and scientific literature on the PubMed website. The PubMed search resulted in finding 136 articles, 15 of which were part of the meta-analysis, according to the specified inclusion / exclusion criteria. A total of 3336 placed short dental implants with a length of ≤ 8 mm and a diameter of ≥ 3 mm were analyzed. The conclusion is that a high cumulative success of short dental implants is possible if the following prosthetic performance indicators are fulfilled: placement of short dental implants in the area of a higher bone density, positioning of implants in the direction that allows axial force transmission, use of rough surface implants with larger diameters and maximum number of threads, achievement of implant protected occlusion, removal of lateral forces on prosthetic restorations, avoidance of use of cantilevers for prosthetic rehabilitation, implant splinting and use of Michigan relaxation splints in case of bruxism.

• Keywords: kratki dentalni implantati; implantoprotetika; omjer kruna – implantat; marginalni gubitak kosti; splintiranje implantata; koncept implantat-zaštićene okluzije (implant-protected occlusion); vertikalna resorpcija kosti
• Keywords (english): short dental implants; implant prosthetics; crown-implant ratio; marginal bone loss; implant splinting; implant protected occlusion; vertical bone resorption
• Language: croatian
• URN:NBN: urn:nbn:hr:127:955265
• Study programme: Title: dental medicine; Study programme type: university; Study level: postgraduate specialist; Academic / professional title: sveučilišni/a magistar/magistra dentalne medicine (sveučilišni/a magistar/magistra dentalne medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2019-10-07 09:05:51