RESUMO A COVID-19 desafiou as profissões e a Implantodontia também tem seus desafios na pandemia. Vários fatores podem interferir no processo de osseointegração e quanto mais fatores associados, maiores os riscos de interferência. A avaliação do risco na indicação da terapia é a principal decisão para definir a melhor técnica, o melhor biomaterial, o melhor acesso cirúrgico e o melhor momento para intervenção. O objetivo desta revisão foi investigar e sintetizar as evidências científicas sobre os fatores que podem interferir na terapia com implantes bucais em meio a uma pandemia. A literatura foi revisada em bancos de dados como PubMed, Web of Science, Sciello e Google Scholar usando as palavras-chave “COVID-19”, “pandemia”, “fatores de risco”, “fator de impacto”, “implantes dentários”, “odontologia”, “saúde bucal”, “osseointegração”, “metabolismo ósseo”, “fatores de risco medicamentosos”, “estresse crônico”, “antidepressivos”, “zinco”, “hidroxicloroquina”, “ivermectina”, “vitaminas”, “corticosteróides”, “riscos cirúrgicos” e “desinfecção”. A presente revisão mostrou que o estresse crônico e a depressão causados pela pandemia, o consequente uso de antidepressivos, o uso de drogas profiláticas e terapêuticas como zinco, vitamina D, hidroxicloroquina e corticosteroides, podem interferir no metabolismo ósseo e consequentemente no estabelecimento da osseointegração e/ou sua manutenção. Qualquer biomaterial osseointegrável pode ser influenciado por fatores sistêmicos e ações de drogas que podem afetar a homeostase do processo inflamatório, proliferação celular e remodelação óssea. A influência desses fatores na terapia com implantes dentários deve ser investigada por meio de novas revisões, estudos observacionais e ensaios clínicos randomizados.

ABSTRACT The COVID-19 has challenged the professions and Implantology also has its challenges in the pandemic. Several factors can interfere with the osseointegration process and more associated factors, greater the interference risks. Risk assessment in the therapy indication is the main decision to define the best technique, the best biomaterial, the best surgical access and the best moment to intervene. The purpose of this review was to investigate and synthesize the scientific evidence on the factors that may interfere with dental implant therapy in the midst of pandemic. The literature was reviewed in databases such as PubMed, Web of Science, Sciello and Google Scholar using the keywords “COVID-19”, “pandemic”, “risk factors”, “impact factor”, “dental implants”, “dentistry”, “oral health”, “osseointegration”, “bone metabolism”, “drug risk factors”, “chronic stress”, “antidepressants”, “zinc”, “hydroxychloroquine”, “ivermectin”, “vitamins”, “corticosteroids”, “surgical risks” and “disinfection”. The present review showed that chronic stress and depression caused by the pandemic, the consequent use of antidepressants, the use of prophylactic and therapeutic drugs such zinc, vitamin D, hydroxychloroquine and corticosteroids, can interfere with bone metabolism and consequently in osseointegration establishment and/or maintenance. Any osseointegrable biomaterial can be influenced by systemic factors and drugs’ actions that can affect the homeostasis of the inflammatory process, cell proliferation and bone remodeling. These factors’ influence on dental implant therapy should be investigated through new reviews, observational studies and randomized clinical trial.

Abstract Horizontal bone loss after tooth extraction is a common finding that demands bone reconstruction in various cases. The aim of this study was to assess the horizontal alveolar status in partially and completely edentulous patients using cone-beam computed tomography (CBCT). In total, 1516 CBCT scans of 1404 adult patients were analyzed. Assessment of the images was performed in accordance with the previously published horizontal alveolar change (HAC) classification, which categorizes horizontal bone defects into four classes: HAC 1, HAC 2, HAC 3 and HAC 4 (from the least severe to the most severe condition). Analysis of 1048 scans from partially edentulous patients presented a distribution of 63.55%, 22.14%, 13.36% and 0.95% in HAC 1, HAC 2, HAC 3 and HAC 4, respectively. Analysis of 468 scans from completely edentulous patient images presented a distribution of 19.87%, 28.63%, 41.67% and 9.83% in HAC 1, HAC 2, HAC 3 and HAC 4, respectively. Based on these results, as in HAC 4, no cancellous bone was found between the cortical buccal and lingual/palatal bone plates, it seems reasonable to state that the absence of cancellous bone is higher in completely edentulous patients than in partially edentulous patients. Therefore, the absence of cancellous bone seems to be higher in completely edentulous than in partially edentulous patients.

Abstract: The lack of guidelines for bone augmentation procedures might compromise decision making in implantology. The objective of this study was to perform a retrospective study to verify the outcomes of horizontal bone reconstruction in implant dentistry with different types of materials and amounts of native bone in the recipient bed to allow for a new guideline for horizontal bone reconstruction. One hundred preoperative CT scans were retrospectively evaluated and categorized in accordance to horizontal bone defects as presence (Group P) or absence (Group A) of cancellous bone in the recipient bed. Different approaches were used to treat the edentulous ridge and the outcomes were defined either as satisfactory or unsatisfactory regarding the possibility of implant placement. The percentage distribution of the patients according to the presence or absence of cancellous bone was 92% for Group P and 8% for Group A. In Group P, 98% of the patients had satisfactory outcomes, and the use of autografts had 100% of satisfactory outcomes in this group. In Group A, 37.5% of the patients had satisfactory outcomes, and the use of autografts also yielded 100% of satisfactory outcomes. The use of allografts and xenografts in Group A had 0% and 33.3% of satisfactory outcomes, respectively. Therefore, it seems reasonable to speculate that the presence of cancellous bone might be predictive and predictable when the decision includes bone substitutes. In cases of absence of cancellous bone in the recipient bed, the use of a vitalized graft seems to be mandatory.