Consideraciones clínicas implantológicas en pacientes periodontales.
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Fecha
2011
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Universidad de Guayaquil. Facultad Piloto de Odontología. Escuela de Postgrado "Dr. José Apolo Pineda".
Resumen
Desde el punto de vista patogénico la placa provoca las misma consecuencias
en el diente y en el implante. Existen parámetros periodontales como índice
de placa, índice gingival, movilidad, profundidad de sondaje, etc. El
tratamiento periodontal pretende tres objetivos: facilitar el acceso a la
superficie radicular para la eliminación de placas y cálculos, establecer una
arquitectura gingival para el control de la placa por parte del paciente, restituir
los tejidos periodontales destruidos por la enfermedad. Los parámetros a
evaluar serian: Profundidad de sondaje, Nivel clínico de inserción, Sondaje
transgingival del hueso alveolar, Reentrada quirúrgica, Radiografías, Estudio
histológico. Es necesario que los registros se tomen antes y después del
tratamiento con la misma angulación por lo que se debe utilizar una férula
oclusal para guiar la sonda. Un objetivo importante de la evaluación
radiográfica preoperatoria del paciente que va a recibir un implante consiste
en determinar la altura y el ancho del hueso disponible para inserción. De
manera ideal, el ancho del hueso debe permitir el recubrimiento completo de
todas las roscas de los implantes en caras vestibular, lingual o palatina. Es
necesario en todos los casos que no haya infección y que exista tanto
suficiente hueso para estabilizar el implante como tejido blando adecuado
para lograr el cierre primario. El uso de las membranas biocompatibles
permite crear una barrera de aislamiento entre el tejido conjuntivo y el lecho
óseo con o sin implantes, favoreciendo con ello la diferenciación especifica de
tejido óseo (Gottlow 1993). En la técnicas quirúrgica además de la elección
del paciente selección del efecto, en el preoperatorio se debe dar un programa
de higiene y control de placa, enjuagues de clorhexidina 0,2%, anestesia
infiltrativa troncular y periapical
From the standpoint of pathogenic plaque causes the same consequences in the tooth and the implant. There periodontal parameters such as plaque index, gingival index, mobility, probing depth, etc. Periodontal treatment aims three objectives: to facilitate access to the root surface for the removal of plaque and calculus, to establish architecture for gingival plaque control by the patient, to restore the periodontal tissues destroyed by disease. The parameters to evaluate would be: probing depth, clinical attachment level, probing transgingival alveolar bone, Reentry surgery, radiographs, histological study. It is necessary that the records were taken before and after treatment with the same angle so that an occlusal splint should be used to guide the probe. An important goal of preoperative radiographic evaluation of patients scheduled to receive an implant is to determine the height and width of bone available for insertion. Ideally, the width of the bone must allow complete coverage of all the threads of the implants in the buccal, lingual or palatal. It is necessary in all cases there is no infection and that there is enough bone to stabilize both the soft tissue implant as appropriate to achieve primary closure. The use of biocompatible membranes to create an insulation barrier between tissue and bone bed with or without implants, thus favoring specific differentiation of bone tissue (Gottlow 1993). In the surgical techniques as well as patient choice selection effect, before surgery should be given a program of hygiene and plaque control, 0.2% chlorhexidine rinses, truncal and periapical infiltration anesthesia.
From the standpoint of pathogenic plaque causes the same consequences in the tooth and the implant. There periodontal parameters such as plaque index, gingival index, mobility, probing depth, etc. Periodontal treatment aims three objectives: to facilitate access to the root surface for the removal of plaque and calculus, to establish architecture for gingival plaque control by the patient, to restore the periodontal tissues destroyed by disease. The parameters to evaluate would be: probing depth, clinical attachment level, probing transgingival alveolar bone, Reentry surgery, radiographs, histological study. It is necessary that the records were taken before and after treatment with the same angle so that an occlusal splint should be used to guide the probe. An important goal of preoperative radiographic evaluation of patients scheduled to receive an implant is to determine the height and width of bone available for insertion. Ideally, the width of the bone must allow complete coverage of all the threads of the implants in the buccal, lingual or palatal. It is necessary in all cases there is no infection and that there is enough bone to stabilize both the soft tissue implant as appropriate to achieve primary closure. The use of biocompatible membranes to create an insulation barrier between tissue and bone bed with or without implants, thus favoring specific differentiation of bone tissue (Gottlow 1993). In the surgical techniques as well as patient choice selection effect, before surgery should be given a program of hygiene and plaque control, 0.2% chlorhexidine rinses, truncal and periapical infiltration anesthesia.
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Palabras clave
RADIOGRAFIA DENTAL, REGENERACION TISULAR GUIADA, TECNICAS QUIRURGICAS