Detecção de desajustes na interface abutment-prótese: implicações da técnica radiográfica e da magnitude do desajuste na região estética
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Data
2023-03-09
Autores
Oliveira, Vanessa Pacheco de
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Universidade Federal do Espírito Santo
Resumo
Misfits in the abutment-prosthesis interface represent a setback in the rehabilitation treatment with dental implants. Periapical radiographs are used as an auxiliary method for assessing misfits at the abutment-prosthesis interface; however, the evidence supporting the use of this diagnostic method is restricted to studies of low to moderate quality. The aim of this in vitro study was to compare the accuracy of 3 periapical radiographic techniques in detecting misfits at the abutment-prosthesis interface in the esthetic region and to assess whether the magnitude of the misfit influences the diagnosis. For this, 15 implants with an internal conical connection were installed in the central incisor region in polyamide maxillae and copings for customized cemented crowns were made in ceramic using a CAD/CAM system. Misfits of 50, 100 and 150 μm were simulated by interposing 1, 2 or 3 polyester strips of 50 μm thickness, respectively, positioned at the abutment-prosthesis interface; the absence of the strip represented the control group. Digital radiographs were obtained using positioners for the following periapical techniques: bisecting (PTB), parallelism (PTP) and modified parallelism (PTM). A total of 180 digital radiographs were evaluated by 2 radiologists and 1 prosthodontist. The values of the area under the receiver operating characteristic curve (Az) were submitted to the Friedman test with post-hoc Durbin-Conover (α = 5%). Statistically significant differences were found (χ² = 22.0; p < 0.05). There was a statistical difference (p < 0.05) between the PTP (Az = 0.873) and PTB (Az = 0.753) techniques for magnitude 50 μm, with the PTP being more accurate. Larger magnitudes showed greater accuracy compared to smaller magnitudes (p < 0.05). In the technical and magnitude interactions, all comparisons had statistical differences (p < 0.05), except for PTP magnitude 100 μm (Az = 0.976) and PTM magnitude 150 μm (Az = 0.998). It was concluded that PTP was more accurate than PTB to detect misfits of 50 µm at the abutmentprosthesis interface and that larger misfits resulted in more accurate diagnoses regardless of the technique used.
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Radiografia dentária digital , Implante dentário , Prótese dentária