Dental implants in patients affected by systemic diseases

Donos, Nikolaos; Calciolari, Elena

doi:10.1038/sj.bdj.2014.911

Cited by 63 publications

(49 citation statements)

References 104 publications

(92 reference statements)

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“…Minor DI surgery (that does not involve autogenous bone grafts, extensive flaps, or osteotomy preparations extending outside the bony envelope) is asserted to be safe regarding the risk of hemorrhage in patients who have an INR value of 2-4, and local hemostatic agents are suggested enough for these patients [43,44]. On the other hand, it should be noted that some medications that are commonly used in dental practice (like metronidazole, erythromycin, and clarithromycin) may increase the anticoagulant effect of warfarin [31].…”

Section: Bleeding Disordersmentioning

confidence: 99%

“…There is no evidence to suggest that bleeding disorders (BDs) are contraindication for placement of DIs [28] or a contraindication for implant survival/success [31]. Since the risk of thromboembolism of interrupting or changing the antiplatelet therapy is higher than the risk of hemorrhage caused by dental implant surgery, invasive dental procedures including dental implant surgery are suggested to perform normally [42].…”

Section: Bleeding Disordersmentioning

confidence: 99%

“…Clinical studies and reviews demonstrate no evidence of contraindication related to DI success in patients with CVD (Table 4), and this disease is registered as a relative complication due to the risk of infective endocarditis. Antibiotic prophylaxis is necessary prior to the surgery [31] according to the guidelines of the American Heart Association's last publish [32,33]. Smoking has a negative impact on the success and survival of dental implants Statistically significant difference with healthy groups.DI, dental implant; SR, survival rate; MBL, marginal bone loss; BoP, bleeding on probing; OR, odds ratio; RR, risk ratio; ND, no data available.…”

Section: Cardiovascular Diseasesmentioning

confidence: 99%

“…Considering the oral anticoagulant therapy (OAT), DI is not contraindicated in patients under an OAT [28,31]. Minor DI surgery (that does not involve autogenous bone grafts, extensive flaps, or osteotomy preparations extending outside the bony envelope) is asserted to be safe regarding the risk of hemorrhage in patients who have an INR value of 2-4, and local hemostatic agents are suggested enough for these patients [43,44].…”

Section: Bleeding Disordersmentioning

confidence: 99%

“…Cardiovascular disease (CVD) compromises the blood flow which may restrict oxygen or nutrients in the osseous tissue, thus is hypothesized to have higher risk of osseointegration failure [29][30][31]. Clinical studies and reviews demonstrate no evidence of contraindication related to DI success in patients with CVD (Table 4), and this disease is registered as a relative complication due to the risk of infective endocarditis.…”

Section: Cardiovascular Diseasesmentioning

confidence: 99%

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Dental Implants in the Medically Compromised Patient Population

Akay¹,

Arısan²

2018

Clinical Trials in Vulnerable Populations

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As a result of the increase of the life expectancy, elder people live with diverse diseases or conditions like systemic disorders, immune-related disorders, and psychiatric issues. Consecutively, practicing clinicians are faced with serving dental implant treatments in such a population comprised of medical and demographic characteristics. Most commonly, implant therapy is performed among patients above middle ages; therefore, clinicians often encounter medically compromised patients. The patients are usually with adverse conditions like bleeding disorders, bone diseases, cardiovascular disease (CVD), and/or immunologic conditions like cancer therapy, steroid or immunosuppressive or antiresorptive medication, alcoholism, smoking, and many others. Nevertheless, only few conditions could be stated for contraindication to dental implant therapy. Besides the broad range of the mentioned dental implant comorbidities smoking seems less prevalent compared to the general population. Dental implants in smoking patients are certainly affected in relation to the failure rate, marginal bone loss, and some other risks of postoperative complications. Hence, smoking or other similar conditions could be accounted as a chronic systemic disorder just like diabetes mellitus or drug usage. Briefly, it seems that establishing the medical and demographic conditions prior to implant therapy along with controlling the systemic diseases or disorders may be more important than the presence of compromise.

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Section: Bleeding Disordersmentioning

confidence: 99%