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Arribas AR, Galbraith BS, Wong ME. The Effect of Medical Status on Long Term Survival of Dental Implants. Oral Maxillofac Surg Clin North Am 2024:S1042-3699(24)00062-1. [PMID: 39266368 DOI: 10.1016/j.coms.2024.08.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/14/2024]
Abstract
Successful dental implant therapy relies on a bone-implant interface that is mechanically strong and capable of dynamic remodeling in response to functional loads. There are a number of medical conditions or therapies that can affect either bone metabolism or the resistance of bone to infection. However, their effects are often mitigated by local factors or individual responses so the impact of these conditions is not clear-cut. This article will review a number of these conditions and therapies and describe existing studies that have studied these conditions to guide practitioners in their implant practice.
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Affiliation(s)
- Alfredo R Arribas
- Katz Department of Oral & Maxillofacial Surgery, UTHealth Houston School of Dentistry, 7500 Cambridge Street Suite 6510, Houston, TX 77054, USA
| | - Bristol S Galbraith
- Katz Department of Oral & Maxillofacial Surgery, UTHealth Houston School of Dentistry, 7500 Cambridge Street Suite 6510, Houston, TX 77054, USA
| | - Mark E Wong
- Katz Department of Oral & Maxillofacial Surgery, UTHealth Houston School of Dentistry, 7500 Cambridge Street Suite 6510, Houston, TX 77054, USA.
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Mosaddad SA, Talebi S, Keyhan SO, Fallahi HR, Darvishi M, Aghili SS, Tavahodi N, Namanloo RA, Heboyan A, Fathi A. Dental implant considerations in patients with systemic diseases: An updated comprehensive review. J Oral Rehabil 2024; 51:1250-1302. [PMID: 38570927 DOI: 10.1111/joor.13683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 10/27/2023] [Accepted: 03/02/2024] [Indexed: 04/05/2024]
Abstract
BACKGROUND Various medical conditions and the drugs used to treat them have been shown to impede or complicate dental implant surgery. It is crucial to carefully monitor the medical status and potential post-operative complications of patients with systemic diseases, particularly elderly patients, to minimize the risk of health complications that may arise. AIM The purpose of this study was to review the existing evidence on the viability of dental implants in patients with systemic diseases and to provide practical recommendations to achieve the best possible results in the corresponding patient population. METHODS The information for our study was compiled using data from PubMed, Scopus, Web of Science and Google Scholar databases and searched separately for each systemic disease included in our work until October 2023. An additional manual search was also performed to increase the search sensitivity. Only English-language publications were included and assessed according to titles, abstracts and full texts. RESULTS In total, 6784 studies were found. After checking for duplicates and full-text availability, screening for the inclusion criteria and manually searching reference lists, 570 articles remained to be considered in this study. CONCLUSION In treating patients with systemic conditions, the cost-benefit analysis should consider the patient's quality of life and expected lifespan. The success of dental implants depends heavily on ensuring appropriate maintenance therapy, ideal oral hygiene standards, no smoking and avoiding other risk factors. Indications and contraindications for dental implants in cases of systemic diseases are yet to be more understood; broader and hardcore research needs to be done for a guideline foundation.
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Affiliation(s)
- Seyed Ali Mosaddad
- Department of Research Analytics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India
- Department of Conservative Dentistry and Bucofacial Prosthesis, Faculty of Odontology, Complutense University of Madrid, Madrid, Spain
- Student Research Committee, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
- Maxillofacial Surgery & Implantology & Biomaterial Research Foundation, Tehran, Iran
| | - Sahar Talebi
- Research Committee, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Seied Omid Keyhan
- Maxillofacial Surgery & Implantology & Biomaterial Research Foundation, Tehran, Iran
- Department of Oral & Maxillofacial Surgery, Gangneung-Wonju National University, Gangneung, South Korea
- Department of Oral & Maxillofacial Surgery, College of Medicine, University of Florida, Jacksonville, FL, USA
- Iface Academy, Istanbul, Turkey
| | - Hamid Reza Fallahi
- Maxillofacial Surgery & Implantology & Biomaterial Research Foundation, Tehran, Iran
- Department of Oral & Maxillofacial Surgery, Gangneung-Wonju National University, Gangneung, South Korea
- Department of Oral & Maxillofacial Surgery, College of Medicine, University of Florida, Jacksonville, FL, USA
- Iface Academy, Istanbul, Turkey
| | - Mohammad Darvishi
- Faculty of Dentistry, Isfahan (Khorasgan) Branch, Islamic Azad University, Isfahan, Iran
| | - Seyedeh Sara Aghili
- Student Research Committee, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Narges Tavahodi
- Student Research Committee, Faculty of Dentistry, Mazandaran University of Medical Sciences, Sari, Iran
| | | | - Artak Heboyan
- Department of Research Analytics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India
- Department of Prosthodontics, Faculty of Stomatology, Yerevan State Medical University after Mkhitar Heratsi, Yerevan, Armenia
- Department of Prosthodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Amirhossein Fathi
- Department of Prosthodontics, Dental Materials Research Center, Dental Research Institute, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
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Barros AWP, Sales PHDH, Feitosa LSG, Carvalho AAT, Leão JC. Is HIV positive a risk factor or contraindication in dental implant therapy? AIDS 2023; 37:2100-2101. [PMID: 37755429 DOI: 10.1097/qad.0000000000003669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/28/2023]
Abstract
HIV pathogenesis affects TCD4+ lymphocytes, causing impairment of the immune system. Thus, the consequent immunological fragility of individuals with the disease and the absence of studies that serve as a guide for clinicians' decision-making make many healthcare professionals recognize it as a synonym of contraindication for oral rehabilitation treatments with dental implants.
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D'Ambrosio F, Amato A, Chiacchio A, Sisalli L, Giordano F. Do Systemic Diseases and Medications Influence Dental Implant Osseointegration and Dental Implant Health? An Umbrella Review. Dent J (Basel) 2023; 11:146. [PMID: 37366669 DOI: 10.3390/dj11060146] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 05/30/2023] [Accepted: 06/02/2023] [Indexed: 06/28/2023] Open
Abstract
The aim of this umbrella review is to evaluate what are the most common medications and systemic diseases that can affect bone-implant integration, the success rate and survival rate of dental implants, peri-implant tissue health, and implant loss. Systematic reviews, with meta-analysis or not, about how systemic diseases and medications influence dental implant osseointegration, survival rate, success rate, and peri-implant diseases, published only in the English language, are electronically searched across the most important scientific databases. The present umbrella review includes eight systematic reviews, and osteoporosis and diabetes are the most investigated pathologies. Systemic diseases, such as neurologic disorders, HIV, hypothyroidism, cardiovascular diseases, and drugs, such as beta blockers, anti-hypertensives, or diuretics do not show a decreased rate of implant osseointegration. It seems that drugs, such as proton-pump inhibitors (PPIs) or serotonin reuptake inhibitors (SSRIs), negatively affect implant osseointegration. Few studies compare the effects of drugs and systemic diseases on the parameters considered in this overview. It is important to underline how the results of this review need to be validated with subsequent and more reviews.
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Affiliation(s)
- Francesco D'Ambrosio
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Salerno, Italy
| | - Alessandra Amato
- Department of Neuroscience, Reproductive Science and Dentistry, University of Naples Federico II, 80138 Naples, Italy
| | - Andrea Chiacchio
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Salerno, Italy
| | - Laura Sisalli
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Salerno, Italy
| | - Francesco Giordano
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Salerno, Italy
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Casula L, Poli A, Clemente T, Artuso G, Capparé P, Gherlone EF. Prevalence of peri-implantitis in a sample of HIV-positive patients. Clin Exp Dent Res 2021; 7:1002-1013. [PMID: 34288560 PMCID: PMC8638315 DOI: 10.1002/cre2.469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2021] [Accepted: 06/25/2021] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES This study aimed to assess the prevalence of peri-implantitis in human immunodeficiency virus (HIV)-positive patients and the presence of a possible correlation between the immunological profile and serological values, of peri-implantitis, and of possible differences between all-on-4 and single crown/bridge prostheses. SUBJECTS AND METHODS This retrospective study included 58 adult HIV-positive patients (222 implants) with either all-in-4 prostheses or single crowns/bridges on at least one dental implant loaded for more than a year who were followed for 3 year (mean follow-up). Data pertaining to the probing pocket depth (PPD), bleeding on probing, and immunological and systemic profile were collected. RESULTS Patients with single crown/bridge implant rehabilitation showed higher prevalence of peri-implantitis (34%) than patients with all-on-4 rehabilitation (0%) (p = 0.012). Patients with all-on-4 rehabilitation were significantly older than those with single crowns/bridges (p = 0.004). Patients with peri-implantitis had implants for a significantly longer duration than those without (p = 0.001), implying that the probability of peri-implantitis increases as the age of implant increases. CONCLUSIONS The prevalence of peri-implantitis was 26% in the HIV-positive patients population. No correlation was found between patients' immunological and serological factors and peri-implantitis. The most important risk factor for peri-implantitis and mucositis was implant age.
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Affiliation(s)
- Luca Casula
- Oral Surgery Resident, Department of DentistryVita‐Salute San Raffaele UniversityMilanItaly
| | - Andrea Poli
- BioEngineeringIRCCS San Raffaele Scientific InstituteMilanItaly
| | - Tommaso Clemente
- Infectious DiseasesIRCCS San Raffaele Scientific InstituteMilanItaly
| | | | - Paolo Capparé
- Dental SchoolVita‐Salute San Raffaele UniversityMilanItaly
| | - Enrico F. Gherlone
- Department of DentistryVita‐Salute San Raffaele University and IRCCS San Raffaele HospitalMilanItaly
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Vidal F, Peres RV, de Souza RC, Gonçalves C, Pavan P, Gonçalves LS. Dental implants in individuals living with HIV-1: Results from a prospective study in patients undergoing highly active antiretroviral therapy. SPECIAL CARE IN DENTISTRY 2021; 42:112-119. [PMID: 34537992 DOI: 10.1111/scd.12646] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 07/29/2021] [Accepted: 08/21/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To assess survival and success rates of dental implants and the occurrence of peri-implant diseases (mucositis/peri-implantitis) in HIV-1-infected individuals. MATERIAL AND METHODS In this prospective study, 13 HIV-1-infected individuals undergoing highly active antiretroviral therapy (with undetectable plasma HIV RNA levels, and CD4+ T cells > 350/mm3 ) were followed after implant placement, as well as 13 non-HIV-1-infected matched controls. Patients enrolled in this study were followed up to 120 months (mean = 40.6 months; standard deviation = 22.2; range 18 -120 months). Twenty-five implants were placed in pristine healed sites for each group and bone augmentation procedures, when needed, were done only for contour augmentation. Patients were enrolled in a strict periodontal/peri-implant supportive therapy protocol with three recalls per year. The two groups were compared regarding subject-level characteristics (age, gender, smoking, diabetes) and implant-level characteristics (marginal bone level, peri-implant health status). RESULTS All the implants healed uneventfully and reached 100% survival rates (after at least 18 months) in both groups. There were no significant differences between groups for peri-implant diseases (mucositis/peri-implantitis) and for all subject-level co-variables (p > .05). Only the variables dental implant prosthesis type (DIPT) (p = .021, d = .86) and follow up (p = .011, d = .77) showed statistically significant differences between groups. CONCLUSION The findings suggest that well-controlled HIV-1-infected individuals are eligible to undergo implant therapy, achieving survival and success rates comparable to non-HIV-1-infected controls.
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Affiliation(s)
- Fábio Vidal
- Postgraduation Program in Dentistry, Estácio de Sá University, Rio de Janeiro, Brazil
| | - Rafael Vidal Peres
- Postgraduation Program in Dentistry, Estácio de Sá University, Rio de Janeiro, Brazil
| | | | - Cristiane Gonçalves
- Postgraduation Program in Dentistry, Estácio de Sá University, Rio de Janeiro, Brazil
| | - Priscila Pavan
- Postgraduation Program in Dentistry, Estácio de Sá University, Rio de Janeiro, Brazil
| | - Lucio Souza Gonçalves
- Postgraduation Program in Dentistry, Estácio de Sá University, Rio de Janeiro, Brazil
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Neumeier TT, Reddy M, Geurs N, Hill J, Neumeier H. Longitudinal Study of Dental Implants in HIV-Positive Patients. J Prosthodont 2021; 31:115-120. [PMID: 34496113 DOI: 10.1111/jopr.13421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/26/2021] [Indexed: 11/27/2022] Open
Abstract
PURPOSE This study compared the clinical outcome of dental implants and their implant-supported restorations over a 3-year period involving patients both positive and negative for the human immunodeficiency virus. MATERIALS AND METHODS Twenty patients testing positive for the human immunodeficiency virus were recruited for this study. Twenty-one negative control patients were also selected, for a total of forty one patients. Diagnostic impressions were collected and cone beam computed tomography images were obtained. Implant size and positioning were planned using cone beam computed tomography software. Two stage or single surgery was performed as determined by the surgeon (periodontist). After a 6-month healing period, definitive impressions were fabricated using polyvinyl siloxane impression material. Implant stability quotient values were obtained at the time of surgery and placement of the restoration. Screw-retained custom titanium abutments were designed, milled, and placed with 25 N·cm torque using a calibrated torque controller. Porcelain fused-to-metal complete coverage restorations were then cemented with elastomeric resin implant cement. Implants and restorations were assessed at 6-month intervals over a period of 3 years for stability, peri-implant health, and patient satisfaction. RESULTS Over the 3-year period, 25 of 42 implants placed in the negative control group were assessed, and 17 of 27 implants placed in the positive control group were evaluated. The overall patient retention rate was 77%. At the 3-year follow up, restorations examined were fully functional and causing no pain. Overall implant retention within the positive group was 96%. Implant retention within the negative control group was 100%. No differences were noted between groups for bone loss based on statistical tests. CONCLUSION Within the limitations of this clinical investigation, the presence of human immunodeficiency virus per se was not a contraindication to dental treatment with implant-supported restorations.
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Affiliation(s)
- Toni Tien Neumeier
- School of Dentistry, University of Alabama at Birmingham, Birmingham, AL
| | - Michael Reddy
- School of Dentistry, University of California San Francisco, San Francisco, CA
| | - Nicolaas Geurs
- School of Dentistry, University of Alabama at Birmingham, Birmingham, AL
| | - Jeff Hill
- School of Dentistry, University of Alabama at Birmingham, Birmingham, AL
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Neeraja M, Garabadu A, Nayak SC, Das M, Dash D, Tiwari A, Nayyar AS. Craniofacial morphology of HIV-infected adolescents undergoing highly active antiretroviral therapy (HAART): An original research. J Orthod Sci 2020; 9:8. [PMID: 33110767 PMCID: PMC7585463 DOI: 10.4103/jos.jos_8_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2020] [Revised: 03/30/2020] [Accepted: 05/15/2020] [Indexed: 12/04/2022] Open
Abstract
OBJECTIVES: To analyze the craniofacial morphology in child patients and adolescents by evaluating the skeletal cephalometric profile of the HIV infected patients in this age group and comparing them with the HIV-negative controls. MATERIALS AND METHODS: The present study was a planned case-control study which included 25 HIV-positive adolescent patients aged between 10 and 18 years (the study group) who were compared with 25 age- and sex-matched HIV-negative adolescent controls (the control group). All the patients had been HIV infected via a vertical transmission with positive serology confirmed in two different tests and had been kept on HAART since they were born. The diagnostic aids used for orthodontic documentation included facial photographs, digital orthopantomographs, lateral teleradiographs, and study models. RESULTS: With reference to the methodologies used for taking the cephalometric values, all the methods used were in strong agreement with each other for almost all the variables studied and had high intra-class correlation coefficient values except Co-A, SN.ANSPNS, and SNB which, too, had a good agreement of 60%. Nevertheless, the agreement was positive for these variables, too, since the P values obtained were found to be statistically significant (P < 0.05). CONCLUSION: Most of the measurements in the HIV-infected adolescents were found to be similar to the ones obtained for the HIV-negative controls, although, the study results highlighted the significance of further studies to be conducted in this regard, especially, the longitudinal study designs wherein the said variables can be studied on a follow-up basis in longitudinal studies to have an idea of the exact changes observed and their pattern in the included groups.
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Affiliation(s)
- M Neeraja
- Department of Dentistry, Great Eastern Medical School and Hospital, Srikakulam, Andhra Pradesh, India
| | - Anand Garabadu
- Department of Orthodontics and Dentofacial Orthopedics, HiTech Dental College and Hospital, Bhubaneswar, India
| | - Subash Chandra Nayak
- Department of Orthodontics and Dentofacial Orthopedics, HiTech Dental College and Hospital, Bhubaneswar, India
| | - Monalisa Das
- Department of Orthodontics and Dentofacial Orthopedics, HiTech Dental College and Hospital, Bhubaneswar, India
| | - Debashish Dash
- Department of Orthodontics and Dentofacial Orthopedics, HiTech Dental College and Hospital, Bhubaneswar, India
| | - Anurag Tiwari
- Department of Orthodontics and Dentofacial Orthopedics, HiTech Dental College and Hospital, Bhubaneswar, India
| | - Abhishek Singh Nayyar
- Department of Oral Medicine and Radiology, Saraswati Dhanwantari Dental College and Hospital and Post-graduate Research Institute, Parbhani, Maharashtra, India
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Halpern LR, Adams DR. Medically Complex Dental Implant Patients: Controversies About Systemic Disease and Dental Implant Success/Survival. Dent Clin North Am 2020; 65:1-19. [PMID: 33213704 DOI: 10.1016/j.cden.2020.08.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Advances in dental implant therapy have created choices to enhance the expectations of dental practitioners and their patients with respect to oral rehabilitation at any age after childhood and regardless of, in most cases, medical disabilities. The medical status of the patient however can significantly influence the success rate of dental implant therapy. This article applies the hierarchy of scientific evidence ranging from case reports, retrospective, prospective cohort investigations, systematic reviews, and meta-analyses criteria in order to determine whether dental implant placement in medically compromised patients yields any detrimental sequelae.
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Affiliation(s)
- Leslie R Halpern
- Oral and Maxillofacial Surgery, University of Utah School of Dentistry, 530 South Wakara Way, Salt Lake City, UT 84108, USA.
| | - David R Adams
- Oral and Maxillofacial Surgery, University of Utah School of Dentistry, 530 South Wakara Way, Salt Lake City, UT 84108, USA
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Does HIV infection affect the survival of dental implants? A systematic review and meta-analysis. J Prosthet Dent 2020; 125:862-869. [PMID: 32694022 DOI: 10.1016/j.prosdent.2020.04.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2020] [Revised: 04/06/2020] [Accepted: 04/06/2020] [Indexed: 11/22/2022]
Abstract
STATEMENT OF PROBLEM Immunosuppression and coinfections associated with human immunodeficiency virus (HIV) infection pose a relative contraindication for dental implant therapy. However, although implants have been placed in patients with HIV with reasonable success, how HIV infection affects their survival is unclear. PURPOSE The purpose of this systematic review of the literature and meta-analysis was to analyze the data on the survival of dental implants in patients with HIV. MATERIAL AND METHODS A search for relevant articles published up to November 2019 was performed in PubMed/Medline and Cochrane databases, Clinicaltrials.gov, and Google Scholar. Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were adopted for the conduct of the systematic review. The most pertinent data were extracted and pooled for qualitative and quantitative analyses with 95% confidence intervals. Heterogeneity was analyzed by using I-squared statistics. RESULTS A total of 8 studies involving 411 individuals with HIV and 1109 implants were included in the meta-analysis. The mean follow-up period was 2.8 years. A pooled estimate of 95% of implant survival rate with 95% confidence interval(92% to 96%) was noted. Heterogeneity across the 8 studies was found to be 41% with moderate true variability. CONCLUSIONS This systematic review demonstrated that HIV infection does not pose a serious threat to implant survival on short-term evaluation, but the evidence is of low quality.
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Duttenhoefer F, Fuessinger MA, Beckmann Y, Schmelzeisen R, Groetz KA, Boeker M. Dental implants in immunocompromised patients: a systematic review and meta-analysis. Int J Implant Dent 2019; 5:43. [PMID: 31776815 PMCID: PMC6881487 DOI: 10.1186/s40729-019-0191-5] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Accepted: 10/16/2019] [Indexed: 01/26/2023] Open
Abstract
Objective Impaired health conditions and related lack of adequate host healing are among the most important conditions that account for dental implant failure. Today clinicians face an increasing number of immunocompromised patients requesting implant-based rehabilitation. To provide clinical evidence for prospective decision-making, the aim of this systematic review and meta-analysis was to analyse the influence of immunodeficiency on dental implant survival. Methods The study was conducted according to the PRISMA Statement and the principles of the Cochrane Collaboration. MEDLINE and Web of Science were searched. Results were calculated by the pooled incidence of implant loss. Reported odds ratios (OR) from fully adjusted models were preferred. Distinct risk estimates were synthesised with 95% confidence intervals. Results A total of 62 publications including 1751 endosseous implants placed in immunocompromised patients were included. For the follow-up of 24 months and longer, the mean survival rate of implants in patients with HIV was 93.1%, chemotherapy was 98.8%, autoimmune disease was 88.75%, after organ transplantation was 100%. Crohn’s disease showed a significant effect on early implant failure and resulted in increased, however not significant, implant loss. Conclusion No significant effect of immunocompromised conditions on implant survival was detectable. Implant-based therapy in immunocompromised patients should not aggravate the general morbidity and must not interfere in life-saving therapies. A careful risk stratification prior implant therapy is fundamental. To further decipher the role of immunosuppression on dental implantology, more data from controlled and randomised studies are needed.
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Affiliation(s)
- Fabian Duttenhoefer
- Department of Oral and Craniomaxillofacial Surgery, University Hospital Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany.
| | - Marc Anton Fuessinger
- Department of Oral and Craniomaxillofacial Surgery, University Hospital Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany
| | - Yasmin Beckmann
- Department of Oral and Craniomaxillofacial Surgery, University Hospital Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany
| | - Rainer Schmelzeisen
- Department of Oral and Craniomaxillofacial Surgery, University Hospital Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany
| | - Knut A Groetz
- Department of Oral and Maxillofacial Surgery, HELIOS Dr. Horst-Schmidt-Kliniken, Academic Teaching Hospital University Mainz, Ludwig-Erhard-Str. 100, 65199, Wiesbaden, Germany
| | - Martin Boeker
- Institute of Medical Biometry and Statistics, Medical Data Science, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
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12
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Rubinstein NC, Jacobson Z, McCausland GL, Dibart S. Retrospective study of the success of dental implants placed in HIV-positive patients. Int J Implant Dent 2019; 5:30. [PMID: 31396731 PMCID: PMC6687790 DOI: 10.1186/s40729-019-0174-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Accepted: 05/06/2019] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Data related to HIV-positive patients with dental implants is short-termed and limited. Recent data showed that both HIV and antiretroviral therapy (ART) could lead to low bone mineral density (BMD). The aim of this study was to determine the success rate of dental implants in HIV-positive patients. MATERIALS AND METHODS Dental files of 67 HIV-positive patients were selected and reviewed retrospectively, and 18 subjects agreed to return for examination. All implants were evaluated using periapical radiographs that were calibrated to measure bone loss. Crestal bone loss, mobility, and lack of infection were the parameters used to determine implant success. RESULTS All dental implants evaluated lacked mobility and infection. Bone loss averaged 0.5 mm in 3.6 years. Subjects were consistent with maintenance and oral hygiene. CONCLUSIONS Within the limitations of this study, the results suggest that the placement of dental implants on HIV-positive patients is safe and effective.
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Affiliation(s)
- Nadine Cordero Rubinstein
- University of Maryland School of Dentistry, 650 W. Baltimore Street, Baltimore, MD, 21201, USA.
- Boston University, Boston, MA, USA.
| | - Zhimon Jacobson
- Department of Restorative Sciences & Biomaterials, Boston University, GSDM, Boston, USA
- Boston University, Boston, MA, USA
| | - Gail Link McCausland
- Department of Periodontology, Boston University, Boston, USA
- Boston University, Boston, MA, USA
| | - Serge Dibart
- Department of Periodontology, Boston University, Boston, USA
- Boston University, Boston, MA, USA
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13
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Sabbah A, Hicks J, MacNeill B, Arbona A, Aguilera A, Liu Q, Gelfond J, Gardner W. A retrospective analysis of dental implant survival in HIV patients. J Clin Periodontol 2019; 46:363-372. [PMID: 30702762 DOI: 10.1111/jcpe.13077] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Revised: 01/11/2019] [Accepted: 01/26/2019] [Indexed: 11/28/2022]
Abstract
AIM This 5 years retrospective cohort survival study compared failure rates of dental implants placed in HIV (+) and HIV (-) patients relative to several risk factors. MATERIALS AND METHODS Between 2006 and 2015, 484 implants placed in HIV (+) patients and 805 implants placed in HIV (-) patients were assessed for survival. The effects of HIV were estimated using propensity weighting. The effects of age, smoking status, diabetes, restoration status, gender, implant type, placement site, hepatitis C status, baseline CD4 count and CD4%, post-placement average CD4%, nadir CD4%, nadir CD4 count and antiviral therapy were analysed. RESULTS Implants placed in HIV (+) patients and HIV (-) patients had similar failure rates (HR = 1.4, p = 0.34). Increased failure rates were observed in HIV (+) patients with baseline CD4% ≤20 (HR = 2.72, p = 0.04), post-placement CD4% average ≤20% (HR = 2.71, p = 0.04), protease inhibitor administration (HR = 2.74, p = 0.04), smoking (HR = 2.61, p = 0.05) and anterior maxillary placement (HR = 5.82, p < 0.01). Hepatitis C coinfection, viral titre, baseline CD4 count, gender, implant type and restoration type were non-contributory. CONCLUSION Implants placed in HIV (+) patients had similar survival rates as HIV (-) patients. Failure rates increase significantly when confounding risk factors are present in HIV (+) patients.
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Affiliation(s)
- Ahmed Sabbah
- Department of Comprehensive Dentistry, School of Dentistry, University of Texas Health San Antonio, San Antonio, Texas
| | - Jeffery Hicks
- Department of Comprehensive Dentistry, School of Dentistry, University of Texas Health San Antonio, San Antonio, Texas
| | - Barbara MacNeill
- Department of Comprehensive Dentistry, School of Dentistry, University of Texas Health San Antonio, San Antonio, Texas
| | - Antonio Arbona
- Department of Comprehensive Dentistry, School of Dentistry, University of Texas Health San Antonio, San Antonio, Texas
| | - Alfonso Aguilera
- Department of Comprehensive Dentistry, School of Dentistry, University of Texas Health San Antonio, San Antonio, Texas
| | - Qianqian Liu
- Department of Epidemiology and Biostatistics, School of Medicine, University of Texas Health San Antonio, San Antonio, Texas
| | - Jonathan Gelfond
- Department of Epidemiology and Biostatistics, School of Medicine, University of Texas Health San Antonio, San Antonio, Texas
| | - Wayne Gardner
- Department of Comprehensive Dentistry, School of Dentistry, University of Texas Health San Antonio, San Antonio, Texas
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Robbins MR. Recent Recommendations for Management of Human Immunodeficiency Virus-Positive Patients. Dent Clin North Am 2018; 61:365-387. [PMID: 28317571 DOI: 10.1016/j.cden.2016.12.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Human immunodeficiency virus (HIV) infection has become a chronic condition. HIV is not a valid reason to deny, delay, or withhold dental treatment. There are no absolute contraindications and few complications associated with comprehensive oral health care treatment delivered in an outpatient setting for asymptomatic HIV-infected patients and clinically stable patients with AIDS. Consultation with the patient's medical provider and modifications in the delivery of dental treatment may be necessary when treating patients with advanced HIV disease or other comorbid conditions. Oral health care is an integral and important part of comprehensive health care for all patients with HIV/AIDS.
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Affiliation(s)
- Miriam R Robbins
- Department of Dental Medicine, Winthrop University Hospital, 200 Old Country Road, Suite 460, Mineola, NY 11501, USA; Department of Oral and Maxillofacial Pathology, Radiology and Medicine, New York University College of Dentistry, 345 E. 24th Street, New York, NY 10010, USA.
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Survival of dental implants placed in HIV-positive patients: a systematic review. Int J Oral Maxillofac Surg 2018; 47:1336-1342. [PMID: 29555240 DOI: 10.1016/j.ijom.2018.02.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Revised: 02/20/2018] [Accepted: 02/23/2018] [Indexed: 01/08/2023]
Abstract
No consensus has been reached on the use of dental implants in human immunodeficiency virus (HIV)-positive patients. This systematic review evaluated dental implants in HIV-positive patients in terms of implant survival and success rates, marginal bone loss, and complications. The review was conducted according to the PRISMA checklist. Two independent reviewers performed a comprehensive search of the PubMed/MEDLINE, Scopus, and Cochrane Library databases for studies published until October 2017. Six studies were selected for review. In total, 821 implants were placed: 493 in 169 HIV-positive patients, and 328 in 135 HIV-negative patients. The mean duration of follow-up was 47.9 months. Weighted mean survival rate, success rate, and marginal bone loss values were calculated for the HIV-positive patients. Mean survival and success rates at the patient level (according to the number of patients) were 94.76% and 93.81%, respectively; when calculated at the implant level (according to the number of implants), these rates were 94.53% and 90.37%, respectively. Mean marginal bone loss was 0.83mm at the patient level and 0.99mm at the implant level. Thus, dental implants are suitable for the rehabilitation of HIV-positive patients with controlled risk factors and normal CD4+ cell counts.
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Craniofacial morphology of HIV-positive children and adolescents undergoing antiretroviral therapy: A pilot study. Am J Orthod Dentofacial Orthop 2018; 153:26-35. [PMID: 29287644 DOI: 10.1016/j.ajodo.2017.05.027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Revised: 02/01/2017] [Accepted: 05/01/2017] [Indexed: 02/07/2023]
Abstract
INTRODUCTION In this study, we aimed to analyze craniofacial morphology by assessing the skeletal cephalometric profiles of HIV-positive patients receiving antiretroviral therapy. METHODS For this study, 21 HIV-positive patients aged between 6 and 17 years (study group) were selected and compared with 21 normoreactive patients (control group), paired by sex and age. The patients were also divided into 3 age ranges (6-8, 9-12, and 13-17 years) considering the pubertal growth spurt as the central event. Eighteen (linear and angular) measurements were traced on teleradiographs by using 2 methodologies. The mean values of each measurement were compared between the study and control groups by age range. RESULTS The majority of the measurements checked in the HIV-positive children and adolescents for the 13-to-17 year age range were diminished, but not enough to generate a statistically significant difference in craniofacial growth. Statistically significant differences (P <0.05) were found only in the inclination of the palatal plane (6-8 years) and the position of the maxilla in the anteroposterior direction (13-17 years). CONCLUSIONS These results led us to conclude that some cephalometric measurements of HIV-positive children and adolescents may be similar to those of normoreactive subjects.
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Vidal F, Vidal R, Bochnia J, de Souza RC, Gonçalves LS. Dental implants and bone augmentation in HIV-infected patients under HAART: Case report and review of the literature. SPECIAL CARE IN DENTISTRY 2017; 37:150-155. [PMID: 28181688 DOI: 10.1111/scd.12219] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The present study reviewed the literature regarding dental implants in HIV-infected patients and reports the long-term follow-up of three clinical cases of patients under HAART that received bone augmentation and dental implants. The first case presents a young patient with a large defect in the mandible, as a consequence of a longitudinal fracture, that was treated with guided bone regeneration (GBR) previously to implant placement. The second case reported is middle-aged man with a fractured upper lateral incisor treated with immediate placement and simultaneous GBR to repair the dehiscence due to the buccal bone resorption. The third case shows an elderly patient that underwent sinus lifting with the simultaneous placement of two implants. All cases were treated after patients were medically controlled and followed for at least 10 years. Controlled HIV-infected patients undergoing HAART may be candidates to implant rehabilitation, as long as their plasmatic HIV viral load and CD4+ T lymphocytes count are within the parameters that indicate immune stability. Long-term stability of soft and hard tissues can be obtained maintaining function and esthetics. However, stronger evidence, based on prospective, controlled clinical trials is needed to provide the dental and medical teams with conclusive data.
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Affiliation(s)
- Fábio Vidal
- Postgraduate Program in Dentistry, Estácio de Sá University, Rio de Janeiro, Brazil. Av. Alfredo Baltazar da Silveira, 580-cobertura, Recreio dos Bandeirantes, Rio de Janeiro, Brazil
| | - Rafael Vidal
- ADITIV lab, Rio de Janeiro, Brazil. Avenida João Cabral de Melo Neto, 350 bloco 1, loja A, Barra da Tijuca, Rio de Janeiro, Brazil
| | - Jeter Bochnia
- Federal University of Rio de Janeiro, Rio de Janeiro, Brazil, Hospital Universitário Clementino Fraga Filho-Rua Professor Rodolpho Paulo Rocco, 325, 2nd floor-Ilha do Fundão, Rio de Janeiro, Brazil
| | - Rodrigo Carvalho de Souza
- Postgraduate Program in Dentistry, Estácio de Sá University, Rio de Janeiro, Brazil. Av. Alfredo Baltazar da Silveira, 580-cobertura, Recreio dos Bandeirantes, Rio de Janeiro, Brazil
| | - Lucio Souza Gonçalves
- Postgraduate Program in Dentistry, Estácio de Sá University, Rio de Janeiro, Brazil. Av. Alfredo Baltazar da Silveira, 580-cobertura, Recreio dos Bandeirantes, Rio de Janeiro, Brazil
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Abstract
Several systemic diseases (and relative medications) have been reported to impair or in some cases complicate dental implant surgery. In broader terms, when dealing with patients suffering from systemic diseases, the monitoring of the medical condition and of the related post-operative complications is of great importance in order to avoid risks which could jeopardise the health of the patient. In this review, the available evidence on implant survival/success, as well as relevant surgical recommendations in patients affected by systemic diseases, are evaluated and when possible, practical suggestions for the clinician are provided.
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Guobis Z, Pacauskiene I, Astramskaite I. General Diseases Influence on Peri-Implantitis Development: a Systematic Review. EJOURNAL OF ORAL MAXILLOFACIAL RESEARCH 2016; 7:e5. [PMID: 27833730 PMCID: PMC5100645 DOI: 10.5037/jomr.2016.7305] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/25/2016] [Accepted: 08/22/2016] [Indexed: 12/16/2022]
Abstract
OBJECTIVES To systematically review the influence of systemic diseases or medications used in their treatment on the dental implant therapy success. MATERIAL AND METHODS The search strategy was implemented on the National Library of Medicine database (MEDLINE) (Ovid) and EMBASE electronic databases between January 2006 and January 2016. Human studies with available English articles analysing the relationship between dental implant therapy success and systemic diseases, such as diabetes mellitus, AIDS/HIV, rheumatoid arthritis, osteoporosis, Crohn's disease, cardiovascular diseases, scleroderma, Sjögren's syndrome, lichen planus, ectodermal dysplasia, post-transplantation status, were included in present review according to the PRISMA guidelines. The review protocol was registered on PROSPERO system with the code CRD42016033662. RESULTS Present review included forty one retrospective and prospective follow-up studies, case-control studies, case report series and cohort studies. Despite some limitations this study reveals positive results of implantation in most systemic conditions that should be interpreted with caution. Influence of cardiovascular diseases on the dental implantation success should be explored deeply, because of controversial results and likelihood of comorbidity expressed by a history of cardiovascular diseases and periodontitis. There is only a weak relationship with bone density in osteoporosis and implant failure. All the other diseases did not show significant effect on implantation success. CONCLUSIONS Recent studies with low strength of evidence and controversy show that systemic diseases may have potential effect on the success of implantation, but further detailed studies are needed to provide these findings.
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Affiliation(s)
- Zygimantas Guobis
- Department of Oral and Dental Pathology, Lithuanian University of Health Sciences, Kaunas Lithuania
| | - Ingrida Pacauskiene
- Department of Oral and Dental Pathology, Lithuanian University of Health Sciences, Kaunas Lithuania
| | - Inesa Astramskaite
- Department of Maxillofacial Surgery, Lithuanian University of Health Sciences, Kaunas Lithuania
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20
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Seregin SS. [On the question of dental implantation follow-up and results assessment in patients with risk factors]. STOMATOLOGII︠A︡ 2016; 95:73-76. [PMID: 27182565 DOI: 10.17116/stomat201695173-76] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- S S Seregin
- Central Research Institute of Dentistry and Maxillofacial Surgery, Moscow, Russia
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21
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Gay-Escoda C, Pérez-Álvarez D, Camps-Font O, Figueiredo R. Long-term outcomes of oral rehabilitation with dental implants in HIV-positive patients: A retrospective case series. Med Oral Patol Oral Cir Bucal 2016; 21:e385-91. [PMID: 26946205 PMCID: PMC4867214 DOI: 10.4317/medoral.21028] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2015] [Accepted: 10/26/2015] [Indexed: 11/18/2022] Open
Abstract
Background The existing information on oral rehabilitations with dental implants in VIH-positive patients is scarce and of poor quality. Moreover, no long-term follow-up studies are available. Hence, the aims of this study were to describe the long-term survival and success rates of dental implants in a group of HIV-positive patients and to identify the most common postoperative complications, including peri-implant diseases. Material and Methods A retrospective case series of HIV-positive subjects treated with dental implants at the School of Dentistry of the University of Barcelona (Spain) was studied. Several clinical parameters were registered, including CD4 cell count, viral load and surgical complications. Additionally, the patients were assessed for implant survival and success rates and for the prevalence of peri-implant diseases. A descriptive statistical analysis of the data was performed. Results Nine participants (57 implants) were included. The patients’ median age was 42 years (IQR=13.5 years). The implant survival and success rates were 98.3% and 68.4%, respectively, with a mean follow-up of 77.5 months (SD=16.1 months). The patient-based prevalence of peri-implant mucositis and peri-implantitis were 22.2% and 44.4% respectively at the last appointment. Patients that attended regular periodontal maintenance visits had significantly less mean bone loss than non-compliant patients (1.3 mm and 3.9 mm respectively). Conclusions Oral rehabilitation with dental implants in HIV-positive patients seems to provide satisfactory results. In order to reduce the considerably high prevalence of peri-implant diseases, strict maintenance programmes must be implemented. Key words:HIV infection, dental implants, oral implantology, complications, peri-implantitis, peri-implant diseases.
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Affiliation(s)
- C Gay-Escoda
- Faculty of Dentistry - University of Barcelona, Campus de Bellvitge UB, Facultat d'Odontologia, C/ Feixa Llarga, s/n, Pavelló Govern, 2 planta, Despatx 2.9, 08907 L'Hospitalet de Llobregat, Barcelona (Spain),
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Gherlone EF, Capparé P, Tecco S, Polizzi E, Pantaleo G, Gastaldi G, Grusovin MG. A Prospective Longitudinal Study on Implant Prosthetic Rehabilitation in Controlled HIV-Positive Patients with 1-Year Follow-Up: The Role of CD4+ Level, Smoking Habits, and Oral Hygiene. Clin Implant Dent Relat Res 2015; 18:955-964. [PMID: 26238779 DOI: 10.1111/cid.12370] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND A recent study showed that implant-prosthetic rehabilitation in well-controlled HIV patients gave slightly worse results than in an healthy population, and failures were all linked to infection. PURPOSE The aim of this study was to examine the associations between the success of implant-prosthetic treatment and systemic CD4+ level, smoking habits, and oral hygiene. MATERIALS AND METHODS This mono-centric study included HIV patients with a stable disease and good oral hygiene requiring implant rehabilitation. Each patient received at least one dental implant. Prosthesis were delivered after 90 days in the upper jaw and 60 days in the lower jaw. Primary outcome measures were prosthetic failures, implant failures, peri-implant marginal bone level changes, and biological complications (peri-implantitis, pus, pain, paresthesia). The possible association with CD4 count, smoking habits, and oral hygiene was analyzed. RESULTS Sixty-eight patients received 194 implants, and 66 patients (190 implants) were followed for 1 year. No significant associations were found between CD4+ count, oral hygiene-associated variables, and any of the outcome measures. If compared with nonsmoking/light smoking patients, patients who smoked >10 cigarettes/day suffered a statistically significant greater number of implant failures (p ≤ .005), presented a comparatively higher number of peri-implantitis (p < .001), as well as a higher frequency of pus (p ≤ .007), and reported pain (p ≤ .009). CONCLUSION Within the limitation of the present study, placement of dental implants in HIV-positive patients with stable disease seems a reasonable treatment option, regardless of CD4+ cell count, provided that they are in a normal range. Oral hygiene variables were not influent in this group of patient following recall appointments, while HIV-positive heavy smokers (>10 cigarettes/day) demonstrated an increased risk of early implant failure, peri-implantitis, episodes of pus, and self-reported pain.
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Affiliation(s)
- Enrico F Gherlone
- Dental School, Vita-Salute University and IRCCS San Raffaele, Milan, Italy
| | - Paolo Capparé
- Dental School, Vita-Salute University and IRCCS San Raffaele, Milan, Italy.
| | - Simona Tecco
- Dental School, Vita-Salute University and IRCCS San Raffaele, Milan, Italy
| | - Elisabetta Polizzi
- Dental School, Vita-Salute University and IRCCS San Raffaele, Milan, Italy
| | - Giuseppe Pantaleo
- Faculty of Psychology, UniSR Social.Lab [Research Methods], Vita-Salute San Raffaele University, Milan, Italy
| | - Giorgio Gastaldi
- Dental School, Vita-Salute University, Milan, Italy.,Maxillofacial Surgery and Dentistry Unit, San Rocco Hospital, Ome, Brescia, Italy
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Rania V, Pellegrino P, Donati G, Ghezzi M, Clementi E, Sparaco A. Long-term Efficacy of Dental Implants in HIV-Positive Patients. Clin Infect Dis 2015; 61:1208. [DOI: 10.1093/cid/civ544] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Gherlone EF, Capparé P, Tecco S, Polizzi E, Pantaleo G, Gastaldi G, Grusovin MG. Implant Prosthetic Rehabilitation in Controlled HIV-Positive Patients: A Prospective Longitudinal Study with 1-Year Follow-Up. Clin Implant Dent Relat Res 2015; 18:725-34. [PMID: 25955953 DOI: 10.1111/cid.12353] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
PURPOSE The clinical trial aimed to evaluate the survival of implant-prosthetic rehabilitation in controlled HIV-positive patients. MATERIALS AND METHODS This mono-centric study included HIV patients with a stable disease, requiring implant rehabilitation, with good oral hygiene. Each patient received at least one dental implant. After 90 days in the upper jaw and 60 days in the lower jaw, the appropriate prosthesis was delivered.Primary outcome measures were prosthetic failures, implant failures, peri-implant marginal bone level changes (MBLCs), and biological complications (peri-implantitis, pus, pain, paresthesia). Data were recorded before the intervention (T0), and 6 (T1) and 12 months (T2) after. RESULTS Implants were positioned in 68 patients (22 females and 46 males; 194 implants). Two dropouts occurred for exacerbation of the disease before the sixth month of follow-up, and 66 patients (with 190 implants) completed the study. Forty-eight patients (70.6%) received total removable dentures; 11 patients (16.2%) received partial prosthesis, and nine patients (13.2%) received single elements.Implant failure occurred in nine patients (15 fixtures out of 190). These were early implant failures due to primary infection (five fixtures out of 190: 2.6%) and to peri-implantitis (10 fixtures out of 190: 5.2%). Prosthetic failure was registered in two patients (3% of patients) due to the loss of all the fixtures. Pus and pain were observed in 4/7 and 3/7 patients with peri-implantitis, respectively. No fractures of fixtures or paresthesia were registered. At T2, the mean peri-implant MBLC was -1.19 ± 0.87 mm. CONCLUSIONS Within its limitations, the study showed that in a well-controlled population of HIV patients implant rehabilitation can be a suitable options with results slightly worse to those obtained in normal population. A higher incidence of peri implant infections in the first six months was present pointing to the need of a proper protocol for infection control.
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Affiliation(s)
- Enrico F Gherlone
- Dental School, Vita-Salute University and IRCCS San Raffaele, Milan, Italy
| | - Paolo Capparé
- Dental School, Vita-Salute University and IRCCS San Raffaele, Milan, Italy
| | - Simona Tecco
- Dental School, Vita-Salute University and IRCCS San Raffaele, Milan, Italy
| | - Elisabetta Polizzi
- Dental School, Vita-Salute University and IRCCS San Raffaele, Milan, Italy
| | - Giuseppe Pantaleo
- Faculty of Psychology, UniSR Social Lab (Research Methods), Vita-Salute San Raffaele University, Milan, Italy
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Ata-Ali J, Ata-Ali F, Di-Benedetto N, Bagán L, Bagán JV. Does HIV infection have an impact upon dental implant osseointegration? A systematic review. Med Oral Patol Oral Cir Bucal 2015; 20:e347-56. [PMID: 25662560 PMCID: PMC4464923 DOI: 10.4317/medoral.20408] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2014] [Accepted: 11/05/2014] [Indexed: 01/06/2023] Open
Abstract
OBJECTIVE A systematic review is made to determine whether human immunodeficiency virus (HIV) infection has an impact upon dental implant osseointegration. STUDY DESIGN A PubMed (MEDLINE) literature search was made of articles published up until 14 April 2014. The systematic review was conducted based on the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA). The quality of the studies included in the review was assessed using the Methodological Index for Nonrandomized Studies (MINORS) and levels of evidence (based on the University of Oxford's Center for Evidence Based Medicine criteria). RESULTS The combinations of search terms resulted in a list of 132 titles. Nine studies finally met the inclusion criteria and were selected for inclusion in the systematic review. A total of 173 dental implants were placed in 80 patients (135 implants in 56 HIV-positive subjects and 38 implants in 24 HIV-negative patients), and a single loss of dental implant osseointegration was recorded in an HIV-positive patient. CONCLUSIONS Our results suggest that dental implant placement in HIV-positive patients does not increase the dental implant failure rate. Prophylactic antibiotic treatment, the administration of highly active antiretroviral therapy, and control of the CD4+ T lymphocyte counts appear to be the main influencing factors in this respect. Given the few studies included in our systematic review, further prospective studies involving larger sample sizes and longer durations of follow-up are required in order to confirm the results obtained.
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Affiliation(s)
- Javier Ata-Ali
- Public Dental Health Service, Arnau de Vilanova Hospital, San Clemente Street 12, 46015-Valencia, Spain,
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Maló P, de Araújo Nobre M, Gonçalves Y, Lopes A. Long-Term Outcome of Implant Rehabilitations in Patients with Systemic Disorders and Smoking Habits: A Retrospective Clinical Study. Clin Implant Dent Relat Res 2015; 18:649-65. [DOI: 10.1111/cid.12346] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- Paulo Maló
- Oral Surgery Department; Malo Clinic; Lisbon Portugal
| | | | | | - Armando Lopes
- Oral Surgery Department; Malo Clinic; Lisbon Portugal
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Stasko SB, Kolhatkar S, Bhola M. Sinus Floor Elevation and Implant Placement via the Crestal and Lateral Approach in Patients With Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome: Report of Two Cases. Clin Adv Periodontics 2014; 4:217-225. [DOI: 10.1902/cap.2013.120092] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2012] [Accepted: 03/10/2013] [Indexed: 11/13/2022]
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Kotsakis GA, Ioannou AL, Hinrichs JE, Romanos GE. A Systematic Review of Observational Studies Evaluating Implant Placement in the Maxillary Jaws of Medically Compromised Patients. Clin Implant Dent Relat Res 2014; 17:598-609. [DOI: 10.1111/cid.12240] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Affiliation(s)
- Georgios A. Kotsakis
- Advanced Education Program in Periodontology; University of Minnesota; Minneapolis MN USA
| | - Andreas L. Ioannou
- Advanced Education Program in Periodontology; University of Minnesota; Minneapolis MN USA
| | - James E. Hinrichs
- Advanced Education Program in Periodontology; University of Minnesota; Minneapolis MN USA
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Vohra F, Al-Rifaiy MQ, Almas K, Javed F. Efficacy of systemic bisphosphonate delivery on osseointegration of implants under osteoporotic conditions: lessons from animal studies. Arch Oral Biol 2014; 59:912-20. [PMID: 24908376 DOI: 10.1016/j.archoralbio.2014.05.016] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2014] [Revised: 05/09/2014] [Accepted: 05/09/2014] [Indexed: 01/13/2023]
Abstract
BACKGROUND The aim was to systematically review the role of systemic bisphosphonate (BP) delivery on osseointegration of implants under osteoporotic conditions. METHODS The addressed focused question was "Does systemic BP delivery enhance osseointegration of implants under osteoporotic conditions?" PubMed/MEDLINE and Google-Scholar databases were searched from 1994 up to and including December 2013 using different combinations of the following keywords: "bone to implant contact", "implant", "bisphosphonate", "osseointegration" and "osteoporosis". Review articles, case-reports, commentaries, letters to the Editor, unpublished articles and articles published in languages other than English were excluded. RESULTS Fifteen animal studies fulfilled our eligibility criteria. Osteoporotic conditions were induced via bilateral ovariectomy (OVX). BPs used in the studies were ibandronate, zoledronic acid and alendronate. Results from 12 studies showed that systemic BP delivery significantly increased bone volume and bone-to-implant contact under osteoporotic conditions. Two studies reported no significant difference in osseointegration among OVX animals with and without systemic BP delivery. In one study, systemic BP delivery negatively influenced implant osseointegration. Rough-surfaced and polished implants were used in 11 and one study respectively. In 3 studies implant surface characteristics remained unclear. CONCLUSION Within the limits of the present study, it is concluded that systemic BP delivery enhances implant osseointegration in animals with induced osteoporotic conditions. However, in a clinical scenario, the potential risk of BP related ONJ in osteoporotic patients undergoing dental implant therapy cannot be disregarded.
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Affiliation(s)
- Fahim Vohra
- Department of Prosthetic Dental Sciences, College of Dentistry, King Saud University, PO Box 60169, Riyadh 11545, Saudi Arabia.
| | - Mohammad Qasim Al-Rifaiy
- Department of Prosthetic Dental Sciences, College of Dentistry, King Saud University, PO Box 60169, Riyadh 11545, Saudi Arabia
| | - Khalid Almas
- Division of Periodontology, School of Dental Medicine, University of Connecticut, Farmington, CT, USA
| | - Fawad Javed
- Eng. A.B. Research Chair for Growth Factors and Bone Regeneration, 3D Imaging and Biomechanical Laboratory, College of Applied Medical Sciences, King Saud University, PO Box 60169, Riyadh 11545, Saudi Arabia.
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Prevalence of calcified carotid artery atheromas in panoramic radiographs of HIV-positive patients undergoing antiretroviral treatment: a retrospective study. Oral Surg Oral Med Oral Pathol Oral Radiol 2014; 117:67-74. [DOI: 10.1016/j.oooo.2013.08.022] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2013] [Revised: 08/23/2013] [Accepted: 08/28/2013] [Indexed: 12/11/2022]
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Diz P, Scully C, Sanz M. Dental implants in the medically compromised patient. J Dent 2013; 41:195-206. [PMID: 23313715 DOI: 10.1016/j.jdent.2012.12.008] [Citation(s) in RCA: 131] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2011] [Revised: 12/03/2012] [Accepted: 12/27/2012] [Indexed: 10/27/2022] Open
Abstract
OBJECTIVE It has been suggested that some local and systemic factors could be contraindications to dental implant treatment. The objective of this paper was to evaluate whether success and survival rates of dental implants are reduced in the medically compromised patient. DATA/SOURCES An extensive literature search was conducted using PubMed/Medline, Scopus, Scirus and Cochrane databases up to November 8, 2012. CONCLUSIONS There are very few absolute medical contraindications to dental implant treatment, although a number of conditions may increase the risk of treatment failure or complications. The degree of systemic disease-control may be far more important that the nature of the disorder itself, and individualized medical control should be established prior to implant therapy, since in many of these patients the quality of life and functional benefits from dental implants may outweigh any risks.
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Affiliation(s)
- Pedro Diz
- Grupo de Investigación en Odontología Médico-Quirúrgica (OMEQUI), School of Medicine and Dentistry, University of Santiago de Compostela, Spain.
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