Utilização da cirurgia guiada na instalação de mini-implantes ortodônticos: aplicação de um protocolo para a prática clínica

Abstract

The usage of cone beam computed tomography associated with CAD/CAM technology produce a reliable prototyped surgical guide and it's increasing the accuracy in positioning the metallic screw, reducing problems of lesion to periodontal ligaments and root surfaces. JUSTIFICATION: As in implantology, that the guided surgery helped reduce the variations between the localization planned and executed on installing metallic implants, the present study justifies itself by analyzing the usage of this technique on orthodontics micro-implants surgery install and suggests a protocol for daily use at clinical attendance. OBJECTIVES: The general aim is evaluate the efficiency of a protocol developed with assistance of guided surgery for orthodontic implant therapy; specifically, it aims to describe the use of virtual planning and condensation silicon for the confection of the prototyped surgical guide molding technique, evaluate the usage of the surgical guide concerning micro-implants installation in posterior regions of maxilla and mandible, and produce a manual of the protocol. METHODS: The patients were submitted to molding collect, acquisition of cone beam computerized tomography for planning, installation surgery, and postoperation tomography for the tridimensional evaluation of the metallic screws sites, wtih a reckoning of angulation deviation and the localization. RESULTS: A total of 41 micro-implants were installed in 16 patients, with a average time of the surgical phase was 2 minutes. Pain absence occurred in 81% of installations according to Visual Analog Scale of Pain (VAS). Emplacement of micro-implants by the labial surface medium deviation was 2,0 ± 0,8 mm on the head (D1), 1,9 ± 0,9 mm central (D2), 1,9 ± 1,0 mm (D3) and 3,2°± 1,4 of long axis angulation (A1). Variations were higher by the lingual surface (2,8 ± 1,6 mm, 3,1 ± 2 mm, 3,5 ± 2,3 mm e 4,4°± 2,3, respectively) and distal surface of inferior molars 4,7 ± 3,3 mm, 4,8 ± 3,1 mm, 4,8 ± 2,9 mm, 4,5° ± 1,6, respectively). CONCLUSION: The offered protocol was efficient and of easy execution, presenting itself as a viable and safe option for daily clinic.