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rev port estomatol med dent cir maxilofac . 2017;58(4):212-218 213

Implantes dentários em pacientes com xerostomia

r e s u m o

Palavras-chave: Objetivos: Estudar o estado de saúde oral e periodontal em pacientes com implantes dentá-
Implantes dentários rios e xerostomia.
Sindroma de Sjögren Métodos: Este estudo transversal analisou um total de 20 pacientes com xerostomia (grupo
Xerostomia de estudo) e 29 pacientes sem xerostomia (grupo controlo). Os dois grupos incluíram um
total de 198 implantes dentários. O estado de saúde oral e periodontal dos pacientes foi
avaliado através do índice de placa, índice de hemorragia, índice gengival, nível clínico de
inserção, profundidade de sondagem, dor à percussão, supuração gengival e qualidade de
vida oral (OHIP-14).
Resultados: A média de idades dos pacientes foi de 59,8±12,04 e o tempo de evolução foi de
3,6± 3,05 anos. O índice de placa foi maior em pacientes com xerostomia que nos pacientes
do grupo controlo (p=0,012). Não foram encontradas diferenças estatisticamente significa-
tivas na doença periodontal entre os grupos (p>0,05). Quinze por cento dos pacientes no
grupo xerostomia apresentaram mucosite e profundidades de sondagem inferiores a 3 mm.
A qualidade de vida global (OHIP-14) foi alta em ambos os grupos.
Conclusões: Os implantes dentários são uma opção de tratamento favorável em pacientes
com xerostomia. (Rev Port Estomatol Med Dent Cir Maxilofac. 2017;58(4):212-218)
© 2017 Sociedade Portuguesa de Estomatologia e Medicina Dentária.
Publicado por SPEMD. Este é um artigo Open Access sob uma licença CC BY-NC-ND
(http://creativecommons.org/licenses/by-nc-nd/4.0/).

rehabilitation. In the absence of the lubricating effect of saliva,
Introduction
the oral mucosa is prone to infection and lesion caused by rub-
In recent decades, the use of implants in dentistry has increa- bing against dental prostheses. When that happens, the prosthe-
sed to become a relatively common treatment. Some patholo- tic retention becomes inadequate, often leading to speech and
11
gies and patient habits constitute risk factors for a successful eating difficulties and deteriorating quality of life. Under these
outcome, but as our knowledge of implant therapies and pa- circumstances, rehabilitation by means of dental implants is of
tient management has increased, the cases in which dental particular interest. 12-17 Implant treatments show high success
implants can be indicated have grown in number. In gene- rates and longitudinal studies conducted among the general po-
1,2
ral, the factors that influence dental implant success include pulation show survival rates that vary between 90 and 95% over
the patient’s health status, the characteristics of the implant 5-10-year follow-ups, which have made implantology one of the
site, the technique employed, and the type of prosthetic reha- most widely used dental treatments during the last 20-30 years. 3-6
bilitation chosen, among others. 1-6 Little scientific literature has been published on dental im-
The term “xerostomia” refers to symptoms (subjective), plant treatment in patients presenting xerostomia and SS, and
while the term “hyposalivation” refers to function (objective) the existing literature consists mostly of individual case repor-
17
in cases of xerostomia. Although the two terms are often ap- ts or small case series involving patients. 15,16 Binon et al. des-
plied as synonyms, patients suffering from xerostomia do not cribed a case of xerostomia caused by SS and osseointegrated
18
necessarily experience hyposalivation. 7-9 Xerostomia usually implants. Isidor et al. found an 84% implant success rate after
19
occurs when salivary flow drops 40% from the original value a 4-year follow-up. Payne et al. found an 88.4% success rate
while hyposalivation occurs with values below 0.1 ml/min. in 26 implants placed in three patients, although the follow-up
Sjögren’s syndrome (SS) is a chronic autoimmune disease period was only two years.
that results from a lymphocyte infiltration of the exocrine glands, We hypothesize that the treatment outcome of implant-
especially tear glands and salivary glands, which leads to pro- -therapy patients with xerostomia and suspected SS is similar
gressive gland damage, consequently causing sicca symptoms to the results obtained in matched healthy controls.
(xerostomia, xerophthalmia); B-lymphocyte hyperactivity is the The objective of this study was to evaluate the dental, perio-
main immunological mechanism involved. That disease may dontal and implantological state of patients with xerostomia.
present as primary SS (pSS) or be associated with another con-
nective tissue diseases such as rheumatoid arthritis or systemic
lupus erythematosus, as what is known as secondary SS (sSS). 10 Materials and methods
Patients usually present a high incidence of dental caries as
a consequence of decreased saliva production. This condition can A total of 89 patients were referred by the Rheumatology Ser-
lead to the loss of teeth and, consequently, a need for prosthetic vice of the Morales Meseguer Hospital (Murcia, Spain) with