Los implantes dentales son una modalidad de tratamiento previsible y fiable para sustituir los dientes que faltan y sostener dentaduras postizas en pacientes edéntulos. Pueden restablecer la salud, forma, función, masticación, articulación y estética oral del sistema estomatognático con índices de éxito plurianual de más del 90 por ciento para implantes en pacientes totalmente [1,2] o parcialmente [3-6] edéntulos. Se han notado algunas variaciones en el éxito de los implantes según la técnica quirúrgica, el protocolo de carga, la ubicación del implante y la calidad ósea, por ejemplo, se han detectado índices de éxito más bajos en los implantes maxilares superiores respecto a los implantes mandibulares inferiores [7,8].
En las últimas décadas la investigación sobre los implantes dentales ha llevado a una extensa modificación de los protocolos quirúrgicos y protésicos.
En cuanto a la superficie de los implantes dentales la opinión general es que las superficies rugosas/microtexturizadas son superiores.
Otras formas de aumentar la superficie del implante incluyen el diseño de la rosca, la longitud y el diámetro del mismo. El diseño del implante debería incorporar las características que más transforman las fuerzas de tensión y de corte durante la masticación y minimizan los componentes de fuerza indeseables.
Otro factor esencial para la estabilidad del tejido óseo periimplantario a largo plazo y para obtener un implante dental suficientemente funcional es la estabilidad de la conexión implante/pilar, que evita roturas del implante y aflojamiento del tornillo y mantiene el nivel óseo periimplantario estable.
Es inevitable que se forme un espacio o microespacio entre el implante y el pilar con un diseño de dos piezas; sin embargo, a veces es posible obtener un microespacio más pequeño en diseños con cambio de plataforma y conectores cónicos por conos Morse, utilizados para transferir el microespacio hacia el eje del implante y reducir el micromovimiento. Esto puede reducir la impulsión de fluido del surco y, por tanto, la pérdida ósea crestal, incluso con implantes introducidos debajo de la cresta alveolar (subcrestales).
El objetivo de este estudio retrospectivo era describir los resultados clínicos y radiológicos de un nuevo sistema de implantes con una topografía de la superficie chorreada con arena y grabada con ácido y una conexión cónica implante/pilar con bloqueo Morse. Los implantes se insertaron en alvéolos íntegros de inmediata extracción de dientes maxilares y mandibulares insalvables y se siguieron clínicamente y radiológicamente después de un tiempo de carga promedio de dos años. El enfoque se dirigió hacia el mantenimiento de la salud periimplantaria y la estabilidad del nivel óseo periimplantario.
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