Simultaneous Extractions, Implant Placement, and Immediate Loading With Hybrid Prosthesis in Patient With Chronic Graft‐Versus‐Host Disease

Abstract

Introduction Full‐arch rehabilitation with simultaneous extractions, implant placement, and loading is an important treatment modality. Many patients that may benefit from this treatment suffer with medical conditions that can compromise the ability to receive this treatment. Chronic graft‐versus‐host disease (cGVHD) is a condition that occurs with 50% to 70% of patient following bone marrow replacement treatment. Oral manifestations of cGVHD include mucosal changes, xerostomia, and rampant caries. Immediate implant placement and loading would be of great benefit to patients with cGVHD. To the author's knowledge, no articles have been published describing simultaneous extractions, implant placement, and immediate loading with a fixed prosthesis in a patient with cGVHD. Case Presentation A 46‐year‐old non‐smoking male presented with rampant severe caries and a history of cGVHD. The patient complained of xerostomia, difficulty with mastication, and embarrassment regarding his condition. After thorough evaluation, medical consultation, and discussion of treatment options, the patient was seen for full‐mouth extractions and immediate placement of dental implants in the mandibular arch. An immediate mandibular hybrid prosthesis and an immediate maxillary complete denture were delivered. Following 6 months of healing, the final mandibular hybrid prosthesis and maxillary complete denture were delivered. Oral manifestations of cGVHD did not negatively affect the treatment. Conclusion Simultaneous extractions, implant placement, and implant loading can be performed in a patient with chronic graft‐versus‐host disease.