Importance Of The Occlusion In The Success Of The Implantation. Case With Syndrome Of Eagle
In February of the 2008, patient A N A , of the 45 years old, male, with homeopathic, was presented for emergency consultation, with complaint of mobility and intense pain in implanted element 36. The preliminary history of this element concerns to a tooth that passed for endodontic treatment and rehabilitation with nucleus and metal ceramic crown, installed in 2004. In 2006, the element 36 presented vertical breaking with loss of the dental element. At this time was suggested the implantation in the region, because the bone conditions were extremely favorable. The implantation was carried through by specialist in this same year. After clinical and radiographic evaluation, about the consultation in Fev/2008, we decided to the removal of the implantation, and this act was carried through in the same day; therefore the implantation was with much mobility (degree 3), generating intense pain, edema and one fibroses around of the implanted part, suggesting not the occurrence of bone integration. After evaluation of the oclusals conditions of this patient, it was requested panoramic and a teleradiography, for analysis of the conditions of the TMJ’s. Such behavior was based on dental history, of two loses in the same area in short space of time beyond the patient has bruxism. For MISCH (2006) “the bruxism increases the magnitude of the force, the duration of the force, changes the direction of the force, becomes the exaggerated type of force more and it can extend it throughout the time”. According to Moraes (2009) “the standard of an ideal occlusion, is the factor most important in the construction of the occlusion and it is of a particular importance for prosthetic on implantations. Beyond the potential for the dysfunction of neuro-muscular that the premature contacts can create, the oclusal force is increased when a high or premature contact is present”. For GOIRIS (1994) In natural teeth the oclusals forces are absorbed by the called mechanism of transmission and neutralization of oclusals forces. However, whenever it deals with implantation of bone integration, this absorption follows other parameters and has other implications, exactly because in the region that the alveolar bone take place, the implantation does not present receivers (proprio receptors) as the periodontal ligament. Moreover, the type of interface of the implantation will be the determinative factor of the behavior of the set " bone-implantation-bulk craniofacial" , related to the loss of the oclusais forces. ROSA and col (2004), associate cases of bruxismo and occlusion with clinical TMJ ; although they do not make any commentary to the use of implantations In the revision of literature many works do not exist relating a link between oclusal trauma and implantation, much less is the prevalence of this relation with the Syndrome of Eagle In our clinical experience we observe that patient carriers of Syndrome of Eagle, beyond revealing pertinent signals and symptoms to the same one, also present as aggravation the changing in the corporal position. This means that must be by the fact that it generates limitations of the movements in the region of head and neck. Causing for consequence, a rotation or alteration of the oclusal plan. And this one it would be an aggravating for the oclusals contacts, that at the moment of the prosthetic installation were within the protocols, would pass to pathological contacts. It is added to this fact of the patient to have bruxism. We believe that the probable causes of this failure had been not the consideration of the agents cited aggravations. Therefore, in our agreement a postural treatment, of the ATMJ’s, the Syndrome of Eagle jointly to the bruxism would be the basic, preceding treatment to the rank of the implantation. REFERÊNCIAS BIBLIOGRÁFICASGOIRIS, Fábio Anibal Jara.- Oclusäo: Seu Envolvimento Nos Implantes De Osseointegraçäo / Oclusion: relationship with osseointegrated implants - BCI;1(2):34-7, abr.-jun. 1994. ilus.MISCH, C. E. et al - BRUXISMO E SEUS EFEITOS NOS TRATAMENTOS DE IMPLANTE - Magazine Oral Implantology - Ano: 2006. Acessado em 07/07/09 e também disponível no site http://188.8.131.52/search?q=cache:v1ke-wlpX_wJ:www.dentalreview.com.br/nova/artigos.php%3Fespecialidade_id%3D14%26acao%3Dcat+%22oclus%C3%A3o+implante+e+DTM%22&cd=7&hl=pt-BR&ct=clnk MORAES, Eduardo Jose e ASSIS, Fernando Xavier de - Princípios De Oclusão Aplicados A Implantodontia. Acesso em 08/07/09 . Disponível no site http://184.108.40.206/search?q=cache:SCs62T4LAaIJ:www.ibi.org.br/Artigos/Princ%25EDpios%2520de%2520oclus%25E3o%2520na%2520Implantodontia.htm+%22oclus%C3%A3o+em+implante%22&cd=1&hl=pt-BR&ct=clnk PEDRO, Maria Jose Carvas --- Ajuste Oclusal . São Paulo Monografia apresentada no curso de especialização de Ortodontia na Faculdade de Odontologia da Zona Leste. São Paulo. 1985. ROSA, R S D. ; OLIVEIRA , P A , RODRIGUES GARCIA, R C M ; DEL BEL CURY, A A – Prevalência De Desrodens Temporomandibulares E Sua Associação Com Fatores Oclusais E Articulares – Brazilian Oral Research vol 18 supplement – september 2004Autores;Maria José Carvas Pedro : especialista em Dores orofaciais e Disfunção de ATM’s, especialista em ortodontia; com habilitação em Homeopatia; mestrado e doutoradoPaulo Marcos Zelante: membro da SBPQO ( Sociedade Brasileira de Pesquisas odontológicas) ; habilitado em Homeopatia; aperfeiçoamento em DTM’s, clínico geral.