Protocolo para la colocación de implantes cigomáticos bajo anestesia localserie de casos

  1. Mauricio Sánchez-Pardo 1
  2. Beatriz Pardal-Peláez 2
  3. Javier Montero 2
  1. 1 Universidad de Salamanca
    info

    Universidad de Salamanca

    Salamanca, España

    ROR https://ror.org/02f40zc51

  2. 2 Departamento de Cirugía. Clínica Odontológica. Universidad de Salamanca
Revista:
Labor dental clínica: Avances clínicos en odontoestomatología

ISSN: 1888-4040

Año de publicación: 2021

Volumen: 22

Número: 3

Páginas: 21-42

Tipo: Artículo

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Otras publicaciones en: Labor dental clínica: Avances clínicos en odontoestomatología

Resumen

Introducción Los implantes cigomáticos son una técnica que permite rehabilitar pacientes con una gran atrofia maxilar. El objetivo principal del trabajo fue elaborar un protocolo quirúrgico y protésico reproducible en la realización de implantes cigomáticos bilaterales acompañados por implantes convencionales bajo anestesia local y medicación oral y evaluar la distancia entre los implantes cigomáticos y el nervio infraorbitario. Materiales y Métodos Se operó a 9 pacientes mujeres que pesaban mas de 70 kg, bajo anestesia local y sedación oral. Se colocaron 19 implantes cigomáticos y 23 implantes convencionales. En ningún caso se realizó Quad Zygoma. La carga de la prótesis provisional fue a los 8 días de la cirugía y los implantes cigomáticos fueron colocados en clasificación de ZAGA 4. Se realizó una radiografía panorámica inicial y otra de control a los 6 meses. Resultados Se colocaron 10 cigomáticos en el primer cuadrante y 9 en el segundo. En el primer cuadrante, el 40% (4/10) de los implantes se situaban en la posición 1.4. En la posición 1.5 se colocaron un 40% (4/10) de los implantes. El 66,1% (6/9) de los implantes cigomáticos en el segundo cuadrante se pusieron en posición 2.5 y el 33,3% (3/9) en posición 2.6. La distancia media del implante cigomático más mesial al nervio infraorbitario del primer cuadrante fue de 14,5 mm. La distancia media del implante cigomático más mesial al nervio infraorbitario del segundo cuadrante fue de 15,5 mm. Se pusieron 10,55 cárpules de articaína al 4% de media. Como medicación oral se usó hemitartarato de zolpidem, dexametasona y clorhidrato de tramadol en todos los pacientes. La dipirona se utilizó solo en cirugías de más de dos horas. Conclusión Cuanto más mesial se encuentre la emergencia del implante cigomático, mayor será la cercanía al nervio infraorbitario. La anestesia local más medicación oral se puede utilizar siempre y cuando no se superen las dos horas y media de cirugía. El protocolo quirúrgico y protésico es reproducible.

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Fuente de los datos: Dialnet