Dental implants in individuals living with HIV‐1: Results from a prospective study in patients undergoing highly active antiretroviral therapy

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/mm 3 ) 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.

Avoiding implant‐related complications in medically compromised patients with or without unhealthy lifestyle/Elevated oxidative stress

“…Neumeier et al, 144 at 3 years, in HIV+ patients with a controlled CD4 count (mean CD4+ T cell count: 603 cells/μL), cART therapy, antibiotic prophylaxis, well‐designed prosthetic restorations, and regular 6‐month maintenance found rates of implant survival and MBL compared to those of healthy patients. Similarly, Vidal et al, 145 in HIV+ patients with CD4+ T cells >350/mm 3 showed an eventless implant healing, an implant survival rate of 100% and the same incidence of peri‐implant disease (mucositis/peri‐implantitis) of healthy patients. Sivakumar et al, 146 also reported a good implant survival rate (95%) in AIDS patients in the short term (2.8 years).…”

Evaluation of Sociodemographic Factors and Prevalence of Oral Lesions in People Living with HIV from Cacoal, Rondônia, Amazon Region of Brazil

“…Another relevant point that might have directly influenced the OL prevalence in PLWH in this study was the regular use of antiretroviral therapy (ART). Since the advent of ART, the life expectancy of PLWH increased, as well as access to information through the internet, and then so too did the demand for dental treatment, including oral rehabilitation with dental implants, which improved dental quality of life significantly in the last few years [ 23 , 24 , 25 ]. The attempt to rehabilitate PLWH with dental implants has been reported since 1998 [ 26 ], and since then papers seems to focus on healing, osseointegration process, longevity of dental implants, guided bone regeneration and peri-implant diseases.…”

Impact of local predisposing/precipitating factors and systemic drivers on peri‐implant diseases

“…Genetics/epigenetics 116,139–141 HIV‐1 142 Medications 143 : Anti‐depressants like selective serotonin reuptake inhibitors (SSSRIs) 116,143–146 …”