{"id":151,"date":"2017-05-08T00:00:00","date_gmt":"2017-05-07T23:00:00","guid":{"rendered":"https:\/\/blog.avinent.com\/2017\/05\/08\/conformacion-del-perfil-de-emergencia-en-implantologia-inmediata\/"},"modified":"2024-11-20T12:48:53","modified_gmt":"2024-11-20T11:48:53","slug":"conformacion-del-perfil-de-emergencia-en-implantologia-inmediata","status":"publish","type":"post","link":"https:\/\/avinent.com\/ca\/blog\/conformacion-del-perfil-de-emergencia-en-implantologia-inmediata\/","title":{"rendered":"Conformaci\u00f3n del perfil de emergencia en implantolog\u00eda inmediata"},"content":{"rendered":"

\t\t\t\tLa demanda est\u00e9tica<\/strong> actual que muchos pacientes presentan, ha hecho que los criterios de \u00e9xito en implantes dentales en el sector anterior<\/strong> se actualicen e impliquen ya no s\u00f3lo la osteointegraci\u00f3n del implante<\/strong>, sino la estabilidad periimplantaria del tejido duro y del tejido blando a largo plazo<\/strong>.<\/p>\n

Esta estabilidad periimplantaria puede verse comprometida cuando ya existe una p\u00e9rdida de tejidos consecuencia de la propia remodelaci\u00f3n inevitable que sufre cualquier alv\u00e9olo despu\u00e9s de la exodoncia de un diente. Es por esta raz\u00f3n que cuando estamos tratando el sector anterior tenemos que ver opciones terap\u00e9uticas que nos permitan reducir o compensar el remodelado inevitable que va a tener ese alv\u00e9olo despu\u00e9s de la exodoncia del diente mediante la regeneraci\u00f3n alveolar o mediante la implantolog\u00eda inmediata.<\/p>\n

Nuestro compromiso con el paciente es poder compensar ese tejido duro y blando que se va a perder para que la colocaci\u00f3n tridimensional del implante sea la correcta, la higienizaci\u00f3n y est\u00e9tica de la corona sobre implante sea \u00f3ptima y la predictibilidad de nuestro tratamiento no se vea comprometida a largo plazo 1<\/sup>.<\/p>\n

El papel que juega hoy d\u00eda la implantolog\u00eda inmediata y la carga inmediata en el sector anterior 2, 3<\/sup> es de capital importancia para poder entender que todo proceso quir\u00fargico de colocaci\u00f3n de un implante inmediato conlleva un correcto manejo del alv\u00e9olo, de la mucosa y del dise\u00f1o de la pr\u00f3tesis provisional de transici\u00f3n hasta llegar a la corona definitiva 4, 5,6<\/sup>.<\/p>\n

Estamos pues ante el llamado equilibrio cirug\u00eda-periodoncia-pr\u00f3tesis, donde las tres especialidades ser\u00e1n las encargadas de ofrecernos un resultado predecible a largo plazo cuando tratamos el sector est\u00e9tico anterior.<\/p>\n

Presentamos a continuaci\u00f3n un caso cl\u00ednico<\/strong> de fractura coronal del 11 con lesi\u00f3n periapical, donde indicamos la exodoncia del diente. Es aqu\u00ed donde se tuvieron en cuenta varias posibilidades de tratamiento.<\/p>\n

Posibilidad 1<\/strong>: Exodoncia del diente con regeneraci\u00f3n alveolar y colocaci\u00f3n del implante diferido
\nPosibilidad 2<\/strong>: Exodoncia del diente y colocaci\u00f3n del implante inmediato<\/p>\n

Despu\u00e9s de la exploraci\u00f3n cl\u00ednica, radiogr\u00e1fica y tomogr\u00e1fica se decidi\u00f3 proceder con la exodoncia del 11, implante inmediato y carga inmediata est\u00e9tica para poder controlar y compensar el remodelado \u00f3seo y de tejido blando que iba a tener la zona despu\u00e9s de la exodoncia 1<\/sup>.<\/p>\n

\"\"\u00a0\"\" \"\"<\/p>\n

Se realiz\u00f3 exodoncia de la pieza 11 y colocaci\u00f3n de un implante Biomimetic Ocean (Avinent Implant System), de 3,5x13mm, guiado prot\u00e9sicamente por f\u00e9rula quir\u00fargica confeccionada con resina que nos ofrec\u00eda la posici\u00f3n tridimensional correcta del diente a restaurar y que nos servir\u00eda a su vez como corona provisional de carga inmediata.<\/p>\n

\"\" <\/p>\n

El torque de inserci\u00f3n fue de 45Ncm, se retir\u00f3 el transportador del implante y se tall\u00f3 el mismo para poder rebasar sobre \u00e9l la corona provisional de la propia f\u00e9rula quir\u00fargica. Siguiendo las pautas de contorno cr\u00edtico y subcr\u00edtico establecidas por \u00d3scar Gonz\u00e1lez7<\/sup>, se coloc\u00f3 la corona provisional atornillada y se rebas\u00f3 al transportador del implante, previamente pintado con op\u00e1quer para poder dejar la corona provisional un total de 4 meses y as\u00ed manejar adecuadamente el contorno de la mucosa. A partir del tercer mes de carga se empez\u00f3 a modificar el perfil de emergencia para conseguir el estado actual de la mucosa.<\/p>\n

<\/p>\n

A los 4 meses se tom\u00f3 una impresi\u00f3n individualizada mediante un transfer de cubeta cerrada customizado con flow, seg\u00fan el perfil de emergencia conseguido con el provisional 8, 9<\/sup>, y se confeccion\u00f3 mediante CAD-CAM\u00a0una corona definitiva metal cer\u00e1mica atornillada al implante (Core3dcentres).<\/p>\n

\u00a0\u00a0\u00a0 <\/p>\n

BIBLIOGRAF\u00cdA<\/strong><\/p>\n

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                            1. Su H1, Gonzalez-Martin O, Weisgold A, Lee E . Considerations of implant abutment and crown contour: critical contour and subcritical contour. Int J Periodontics Restorative Dent. 2010 Aug;30(4):335-43.<\/li>\n<\/ol>\n<\/li>\n<\/ol>\n
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                                1. Hinds KD. Custom impression coping for an exact registration of the healed tissue in the esthetic implant restoration. Int J Periodontics Restorative Dent. 1997 Dec;17(6):584-91.<\/li>\n<\/ol>\n<\/li>\n<\/ol>\n
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                                    1. Papadopoulos I1, Pozidi G, Goussias H, Kourtis S. Transferring the emergence profile from the provisional to the final restoration. J Esthet Restor Dent. 2014 May-Jun;26(3):154-61. doi: 10.1111\/jerd.12068. Epub 2013 Dec 17.<\/li>\n<\/ol>\n<\/li>\n<\/ol>\n

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                                      La demanda est\u00e9tica actual que muchos pacientes presentan, ha hecho que los criterios de \u00e9xito en implantes dentales en el sector anterior se actualicen e impliquen ya no s\u00f3lo la osteointegraci\u00f3n del implante, sino la estabilidad periimplantaria del tejido duro y del tejido blando a largo plazo. Esta estabilidad periimplantaria puede verse comprometida cuando ya […]<\/p>\n","protected":false},"author":2,"featured_media":152,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"inline_featured_image":false,"footnotes":""},"categories":[37],"tags":[],"profesional_medics":[133],"segment":[170],"class_list":["post-151","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-casos-clinicos","profesional_medics-dr-daniel-capitan-maraver-dr-manuel-fuentes-ortiz","segments-implantes"],"acf":[],"yoast_head":"\nLa demanda est\u00e9tica actual que muchos pacientes<\/title>\n<meta name=\"description\" content=\"La demanda est\u00e9tica actual que muchos pacientes presentan, ha hecho que los criterios de \u00e9xito en implantes dentales en el sector anterior\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" 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