Regeneração tecidual guiada em implantodontia: Relato de caso clínico

Introduction: At a cellular and molecular level, tissue engineering offers numerous advantages that meet the needs of the injured tissue or organ for the bone regeneration process in buccomaxillofacial surgeries. To achieve this, it is necessary to understand the chemical, physical, and biological processes of both the biological material and the target biological niche. Objective: It was to carry out a concise systematic review of the main processes of bone formation and regeneration using molecules and cells as biostimulators in buccomaxillofacial surgeries. Methods: The PRISMA Platform systematic review rules were followed. The search was carried out from December 2023 to February 2024 in the Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: A total of 182 articles were found, 60 articles were evaluated in full and 36 were included and developed in the present systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 12 studies with a high risk of bias and 20 studies that did not meet GRADE and AMSTAR-2. Most studies did not show homogeneity in their results, with X2=54.7%>50%. The bone regeneration process occurs through the activation of osteoblasts and vascular control guided by PDGFs and TGF-β. These growth factors also promote matrix formation and osteoblast differentiation. Some biodegradable natural polymers (chitosan®) associated with inorganic materials such as tricalcium phosphate were tested as spongy carriers for PDGF-BB. Chitosan® has been attributed to hemostatic properties, inducing bone formation and regulating the release of bioactive agents. The use of platelet-rich plasma and mesenchymal stem cells (exosomes and microRNAs) has been indicated and used in other areas of oral and buccomaxillofacial surgery, accelerating a process of bone regeneration that normally already occurs and this process continues its path until the formation of bone mature.

Section: Major Clinical Outcomesmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Main processes of bone formation and regeneration through molecules and cells as biostimulators in buccomaxillofacial surgery: a systematic review

Inada,

Beneti

2024

“…In this context, the optimization of faster and more accurate techniques by dentists and postoperative surgeons with better results and quality of life, stimulated the development of numerous software and hardware to perform computer-guided surgeries, the so-called Virtual Surgeries (VS). [7]. In this sense, it is essential to perform Computed Tomography (CT) on the patient [8].…”

Section: Introductionmentioning

confidence: 99%

Guided bone regeneration in implant dentistry: a systematic review

Esteves,

Bianchini,

Gonzatti

et al. 2023

Introduction: The rehabilitation of the dental arch with osseointegrated implants makes it possible to improve the quality of life of patients. Guided bone regeneration (GBR) has been applied to replace lost bone to allow the implant to be fully integrated and maintained during functional loading. GBR is considered one of the most commonly applied methods to reconstruct alveolar bone and to treat peri-implant bone deficiencies. Objective: It was to develop a systematic review to highlight the main approaches of guided surgery to promote bone regeneration in implant dentistry. Methods: The systematic review rules of the PRISMA Platform were followed. The search was carried out from March to May 2023 in the Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases, using articles from 1977 (Golden pattern - Bra°nemark et al. ) to 2023. Results and Conclusion: A total of 117 articles were found, 38 articles were evaluated and 28 were included and developed in this systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 22 studies with a high risk of bias and 15 studies that did not meet GRADE. It was concluded that the application of a membrane to prevent nonosteogenic tissues from interfering with bone regeneration is a fundamental principle. Membrane properties and biological outcomes drive bone regeneration in membrane-covered defects. Barrier membranes play the role of preventing the invasion of soft tissue by exiting the mucosa and creating an underlying space to support bone growth. Collagen membranes have excellent biological properties and bone regeneration results. While collagen membranes do not provide sufficient mechanical protection of the covered bone defect, titanium-reinforced membranes, and non-resorbable membranes need to be removed in a second surgery.

“…Many patients, elderly or not, sought implantsupported rehabilitation, but there is a need for some adjustments that lead to the consequent demand for regenerative procedures for maxillary reconstructions [1,2,6]. These patients can often present pathological changes, or make use of medications, which may alter bone healing [7].…”

Section: Introductionmentioning

confidence: 99%

Biomaterials, surgical processes and bone formation for dental implants: a systematic review

Passos¹,

Idalgo²,

Pereira³

et al. 2023

Introduction: Several factors have been reported related to implant success, such as the development and maintenance of healthy peri-implant soft tissues. The development of biomaterials for use in dental clinics in recent years has represented a powerful therapeutic tool in the correction of bone defects. Objective: The present study aimed to carry out a systematic review of the main approaches to the use of biomaterials, surgical methods, and bone regeneration for dental implants. Methods: The systematic review rules of the PRISMA Platform were followed. The search was carried out from January to March 2023 in the Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases, using articles from 1991 to 2022. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed accordingly, according to the Cochrane instrument. Results and Conclusion: A total of 204 articles were found, 78 articles were evaluated and 66 were included and developed in this systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 96 studies with a high risk of bias and 20 studies that did not meet GRADE. For a successful dental implant practice, osseointegration is essential. However, it is a complex process with many factors interfering in the formation and maintenance of bone tissue around the implant, such as topography and surface roughness, biocompatibility, and loading conditions. The dental surgeon must master the knowledge of the healing process of the post-extraction sockets, to provide correct planning of the cases. The optimized processes of implant dentistry and biomaterials allow the installation of implants in areas of low bone thickness, width, and height, with simpler surgeries and greater success rates and patient comfort.