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

Enrico F. Gherlone, Paolo Capparé, Simona Tecco, Elisabetta Polizzi, Giuseppe Pantaleo, Giorgio Gastaldi, Maria Gabriella Grusovin

Research output: Contribution to journalArticle

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.

Original languageEnglish
Pages (from-to)955-964
Number of pages10
JournalClinical Implant Dentistry and Related Research
Volume18
Issue number5
DOIs
Publication statusPublished - Oct 1 2016

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Oral Hygiene
Habits
Longitudinal Studies
Rehabilitation
Smoking
HIV
Prospective Studies
Peri-Implantitis
Suppuration
CD4 Lymphocyte Count
Tobacco Products
Outcome Assessment (Health Care)
Pain
Dental Implants
Paresthesia
Maxilla
Jaw
Prostheses and Implants
Light
Bone and Bones

Keywords

  • AIDS
  • HIV
  • implant
  • implant survival
  • implantology
  • osseointegration
  • peri-implantitis

ASJC Scopus subject areas

  • Oral Surgery
  • Dentistry(all)

Cite this

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title = "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",
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.",
keywords = "AIDS, HIV, implant, implant survival, implantology, osseointegration, peri-implantitis",
author = "Gherlone, {Enrico F.} and Paolo Cappar{\'e} and Simona Tecco and Elisabetta Polizzi and Giuseppe Pantaleo and Giorgio Gastaldi and Grusovin, {Maria Gabriella}",
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T1 - A Prospective Longitudinal Study on Implant Prosthetic Rehabilitation in Controlled HIV-Positive Patients with 1-Year Follow-Up

T2 - The Role of CD4+ Level, Smoking Habits, and Oral Hygiene

AU - Gherlone, Enrico F.

AU - Capparé, Paolo

AU - Tecco, Simona

AU - Polizzi, Elisabetta

AU - Pantaleo, Giuseppe

AU - Gastaldi, Giorgio

AU - Grusovin, Maria Gabriella

PY - 2016/10/1

Y1 - 2016/10/1

N2 - 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.

AB - 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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KW - osseointegration

KW - peri-implantitis

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