RECONSTRUÇÃO DE MAXILA ATRÓFICA COM REGENERAÇÃO ÓSSEA GUIADA ASSOCIADA AO L-PRF: RELATO DE CASO
DOI:
https://doi.org/10.66104/30m1pj32Palabras clave:
Maxilla atrophic. Guided bone regeneration. Platelet-rich fibrin. Bone reconstruction.Resumen
Introdução: A reabilitação de pacientes com maxila atrófica representa um dos maiores desafios da implantodontia contemporânea, uma vez que a reabsorção óssea progressiva decorrente da ausência dental prolongada compromete o volume e a densidade óssea necessários para o tratamento reabilitador. A Regeneração Óssea Guiada (ROG) associada à Fibrina Rica em Plaquetas (L-PRF) surge como uma abordagem biologicamente fundamentada, capaz de promover ganho ósseo expressivo e favorecer a cicatrização tecidual por meio da liberação gradual de fatores de crescimento, criando um microambiente favorável à neoformação óssea em rebordos alveolares severamente atróficos. Objetivo: Relatar um caso clínico de reconstrução de maxila atrófica por meio da associação entre ROG e L-PRF, descrevendo de forma sistematizada a sequência do tratamento cirúrgico, os biomateriais utilizados e os resultados clínicos obtidos ao longo do acompanhamento pós-operatório. Relato de caso: Paciente do sexo masculino, 52 anos, com edentulismo total na maxila e rebordo alveolar severamente atrófico, foi submetido a protocolo de reconstrução óssea por meio de ROG com xenoenxerto bovino desproteinizado associado ao L-PRF e membrana de colágeno reabsorvível. O processo de cicatrização transcorreu sem intercorrências, com ausência de deiscências, exposição de membrana ou infecção do enxerto em todas as consultas de acompanhamento realizadas. O paciente encontra-se em fase de acompanhamento pós-operatório, aguardando a realização da tomografia computadorizada de feixe cônico de controle prevista para seis meses após o procedimento, na qual se espera confirmar ganho ósseo médio entre 5 e 7 mm em altura e entre 3,0 e 4,5 mm em espessura vestibulolingual ao longo do arco maxilar reconstruído. Conclusão: A associação entre ROG e L-PRF demonstrou ser uma abordagem viável, segura e promissora na reconstrução da maxila atrófica, com evolução clínica pós-operatória favorável e perspectivas de ganho ósseo expressivo a ser confirmado pelos exames de controle ainda pendentes. Ressalta-se que os resultados descritos são restritos ao caso apresentado, sendo necessários estudos com maior casuística para a consolidação desse protocolo.Descargas
Referencias
1. Aghaloo TL, Misch C, Lin GH, Iacono VJ, Wang HL. Bone Augmentation of the Edentulous Maxilla for Implant Placement: A Systematic Review. Int J Oral Maxillofac Implants. 2016; 31:19-30.
2. Andrea P, Carbone D, Soda G, Polimeni A, Pacifici L. Guided bone regeneration procedure with platelet-rich fibrin (PRF) membranes in resolution of a severe maxillary bone defect: report of case. Senses Sci. 2015; 2(1):64-70.
3. Baru O, Buduru SD, Beridian-Neagoi I, Leucuta DC, Roman AR, Talmaceanu D, Silvasan H, Badea ME. Autologus Leucocyte and Platelet Rich Fibrin (L-PRF) - is it a competitive solution for bone augumentation in maxillary sinus lift? A 6-month radiological comparision between xenografts and L-PRF. Medicine and Pharmacy Reports 2024; 97 (2): 222-233.
4. Chenchev IL, Ivanova VV, Neychev DZ, Cholakova RB. Application of platelet-rich fibrin and injectable platelet-rich fibrin in combination of bone substitute material for alveolar ridge augmentation - a case report. Folia Med (Plovdiv). 2017;59(3):362-6.
5. Cortellini S, Castro AB, Temmerman A, Van Dessel J, Pinto N, Jacobs R, et al. Leucocyte- and platelet-rich fibrin block for bone augmentation procedure: A proof-of-concept study. J Clin Periodontol. 2018;45(5):624-634.
6. Damsaz M, Castagnoli CZ, Eshghpour M, Alamdari DH, Alamdari AH, Noujeim ZEF, Haidar ZS. Evidence-Based Clinical Efficacy of Leukocyte and Platelet-Rich Fibrin in Maxillary Sinus Floor Lift, Graft and Surgical Augmentation Procedures. Front Surg. 2020; 24(7):537138.
7. Dohan D, Choukroun J, Diss A, Dohan S, Dohan A, Mouhyi J, Gogly B. Platelet-rich fibrin (PRF): a second-generation platelet concentrate. Part I: technological concepts and evolution. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2006;101(3):37-44.
8. Jensen SS, Terheyden H. Bone augmentation procedures in localized defects in the alveolar ridge: clinical results with different bone grafts and bone-substitute Materials. Int J Oral Maxillofac Implants. 2009; 24:218-36.
9. Liu M, Liu Y, Luo F. The role and mechanism of platelet-rich fibrin in alveolar bone regeneration. Biomed Pharmacother. 2023; 168:115795.
10. Malzoni C, Pichotano E, Paula L. Combination of leukocyte and platelet-rich fibrin and demineralized bovine bone graft enhanced bone formation and healing after maxillary sinus augmentation: a randomized clinical trial. Clin Oral Invest. 2023; 27: 5485-98.
11. Milillo L, Petruzzi M. Guided Bone Regeneration with Occlusive Titanium Barrier: A Case Report and Clinical Considerations. Biomimetics. 2023; 8 (1): 106.
12. Nizam N, Eren G, Akcali A, Donos N. Maxillary sinus Augmentation with leukocyte and platelet-rich fibrin and deproteinized bovine bone mineral: a split-mouth histological and histomorphometric study. Clin Oral Implants Res. 2018; 29:67-75.
13. Rocchietta I, Simion M, Hoffmann M, Trisciuoglio D, Benigni M, Dahlin C. Vertical Bone Augmentation with an Autogenous Block or Particles in Combination with Guided Bone Regeneration: A Clinical and Histological Preliminary Study in Humans. Clin Implant Dent Relat Res. 2016;18(1):19-29.
14. Strauss FJ, Nasirzade J, Kargarpoor Z, Stähli A, Gruber R. Effect of platelet-rich fibrin on cell proliferation, migration, differentiation, inflammation, and osteoclastogenesis: a systematic review of in vitro studies. Clin Oral Investig. 2020;24(2):569-584.
15. Urban IA, Montero E, Monje A, Sanz-Sánchez I. Effectiveness of vertical ridge augmentation interventions: a systematic review and meta-analysis. J Clin Periodontol. 2019; 46:319-39.
16. Valladão A, Monteiro M, Joly J. Guided bone regeneration in staged vertical and horizontal bone argumentation using platelet-rich fibrin associated with bone grafts: a retrospective clinical study. Int J Implant Dent. 2020; 6 (72).
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Derechos de autor 2026 Maria Nayara Quaresma Bezerra, Giuseppe Mazzaglia, Emerson Eduardo Toldo, Cíntia Moreira Gonçalves, Vitor Rodrigues da Silva, Ana Clara Barbosa Silva, Maria Vitória de Souza Lima, Cristian Duane Pires, Evllyn Maelly Peixoto Pereira, Jonathan Henrickson Costa Souza, Tainá Cordeiro de Souza, Naiely Silva Bezerra, Wellington Ferreira Souza, Evelyn Carla Leal Costa, Lorena Aparecida da Silva Moura
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