COVID-19大流行对种植牙治疗可能产生的影响:叙述性综述

Maria Cristina Pedrazini, Larissa Pavanello, A. Pelegrine
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引用次数: 0

摘要

新冠肺炎疫情给专业带来了挑战,种植医学也面临着挑战。干扰骨整合过程的因素有多种,相关因素越多,干扰风险越大。治疗指征中的风险评估是确定最佳技术、最佳生物材料、最佳手术途径和最佳干预时机的主要决定因素。本综述的目的是调查和综合在大流行期间可能干扰种植牙治疗的因素的科学证据。在PubMed、Web of Science、Sciello和谷歌Scholar等数据库中检索相关文献,检索关键词为“COVID-19”、“大流行”、“危险因素”、“影响因素”、“牙种植体”、“牙科”、“口腔健康”、“骨整合”、“骨代谢”、“药物危险因素”、“慢性压力”、“抗抑郁药”、“锌”、“羟氯喹”、“伊维菌素”、“维生素”、“皮质类固醇”、“手术风险”和“消毒”。目前的审查表明,大流行引起的慢性压力和抑郁,随之而来的抗抑郁药的使用,锌、维生素D、羟氯喹和皮质类固醇等预防性和治疗性药物的使用,可干扰骨代谢,从而影响骨整合的建立和/或维持。任何可骨整合的生物材料都会受到全身因素和药物作用的影响,从而影响炎症过程、细胞增殖和骨重塑的稳态。这些因素对种植牙治疗的影响需要通过新的综述、观察性研究和随机临床试验来研究。
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The possible impact of COVID-19 pandemic on dental implant therapy: narrative review
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.
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