Doctor, ¿cuánto tiempo duran los implantes? – por Dr. Juan Antonio Hueto Madrid

En el ultimo editorial de la Revista Española de Cirugía Oral y Maxilofacial su editor, el Dr. Luís Naval, sacaba esta pregunta a la palestra.

Seguro que a todos nosotros nos la han hecho nuestros pacientes alguna vez. A pesar que la literatura científica demuestra sólidamente la estabilidad a largo plazo de los tratamientos con implantes, la existencia de grandes cantidades de implantes instalados y en funcionamiento nos ha de permitir evaluar no sólo la supervivencia de implantes, sino si, reamente, la calidad funcional y estética del tratamiento cumple con el paso del tiempo las expectativas de cuando fue realizado.

Los tratamientos restauradores deben planificarse para durar y es necesario evaluar si tanto la planificación biomecánica como los materiales han cumplido los objetivos. En cualquier tratamiento es importante la colaboración del paciente y debe ser un sujeto activo en el mantenimiento de su salud oral. Una adecuada higiene y un uso razonable de su restauración contribuyen al éxito a largo plazo. La importancia de la férula de descarga; en qué casos es necesaria; cómo debe utilizarse; qué impacto tiene en la duración a largo plazo debería ser motivo de estudio. La salud de los tejidos blandos periimplantarios es un factor muy importante en la estabilidad del tratamiento. La periimplantitis es hoy en día motivo de intensos estudios, pues es la causa de muchos fracasos tardíos. La investigación se centra en determinar qué pacientes presentan mayor riesgo, cuáles han de ser las medidas preventivas y de diagnóstico precoz y, una vez establecida, cuáles son las formas de tratamiento más efectivas.  El impacto como factor favorecedor de periimplantitis de las superficies tratadas frente a las mecanizadas lisas sigue siendo motivo de controversia.

 

En cualquier caso, la respuesta a la pregunta que titula este editorial sería que sabemos que duran mucho tiempo, pero que no sabemos cuánto. Como cualquier prótesis la duración dependerá de la calidad de los materiales y el diseño biomecánico, de la respuesta tisular, de un uso razonable y un mantenimiento  adecuado.

 


Dr. Juan Antonio Hueto Madrid

  • - Licenciado en Medicina y Cirugía por la Universidad de Barcelona
  • - Cirujano Oral y Maxilofacial
  • - Médico Adjunto del Servicio de Cirugía Oral y Maxilofacial del Hospital Universitario Vall d’Hebrón de Barcelona
  • - Profesor asociado de la Facultad de Medicina de la UAB
  • - Tutor de formación médica especializada del Hospital Universitario Valld’Hebrón de Barcelona
  • - Director del grupo de investigación de “Robótica y Cirugía” de la “Fundació per la Recerca dels Hospitals Vall d’Hebrón”
  • - Miembro de la junta directiva de la Sociedad Catalano-Balear de Cirugía Oral y Maxilofacial
  • - Miembro numerario de la Sociedad Española de Cirugía Oral y Maxilofacial, Sociedad Española de Cirujanos de Cabeza y Cuello, European Association for Cranio-Maxillofacial Surgery y International Association of Oral and Maxillofacial Surgery.

 

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