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3 year study of dental implant in HIV positive patients
EAO Online Library. Neumeier T.
Oct 9, 2018; 232667
Toni Neumeier
Toni Neumeier
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Abstract
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Life expectancy of HIV+ patients has increased and accordingly their need for implant dental care. Very few studies and case reports have documented the clinical long-term success of dental implant therapy with HIV patients. This study demonstrates that such success is achievable. Compare HIV+ and control patients' implant-supported restorations, evaluating periodontal health and prosthesis condition 3 years post prosthesis placement. Yearly follow-up on implant mobility, gingival and plaque indexes, bone loss measurement, Esthetic and JEMT indexes and patient satisfaction survey.20 HIV positive and 21 HIV negative patients recruited and signed IRB consent form. Patients’ medical dental histories reviewed, meeting criteria including nonsmoker, controlled diabetes, controlled hypertension and no osteoporosis. Patients’ diagnostic impressions collected and radiographic guide fabricated. CBCT image with radiographic guide obtained. Implant size and position planned utilizing CBCT software. Implants placed by Periodontists. Final impressions with PVC obtained after 4-6 months healing. ISQ values assessed at implant placement and prosthesis delivery. Titanium custom abutments fabricated and torqued with 25N. Porcelain metal crowns (PFM) cemented with Premier implant cement. Patients placed on 6 months’ recall to assess implant stability (0-normal to 2), gingival and plaque indexes (0-normal to 2), JEMT (0-no papilla to 4) and Esthetic Index (0- excellent to 2) and photos and x-ray were taken. Patient satisfaction survey recorded.22 male 19 female patients+ age 28 to 70 years+ 6 Asian, 12 African American, 21 Caucasian, 2 others. HIV patients' CD4 counts range 194-1273. 17 HIV negative patients and 14 HIV patients completed 3 year follow up. 32 implants on HIV negative and 28 on HIV positive ranging from central incisor to mandibular 1st molar. ISQ scores were above 65 at prosthesis delivery. Implant stability recorded “0“ (no mobility). Implant gingival and plaque index “0” to “1” with no or minimum plaque accumulation and bleeding on probing except 1 HIV patient had peri-implant suppuration. No peri-implant radiolucency present+ no significant bone loss around the implants observed on the x-ray. Implant crown aesthetic index “0” to 1”, indicating excellent to satisfactory aesthetic. JEMT index range from 0 to 3 and most of patients are 2 which indicate half or more of interdental papilla present. Patient’s satisfaction surveys show all patients are pleased with the aesthetic outcome. Only one of 60 implant failed and one HIV+ patient had peri-implantitis. Study progress to date shows that long term success of implant treatment on HIV patients can be achieved through proper treatment plan, precise implant placement and well-designed prosthetic restoration. A larger HIV population study is indicated to provide evidence for treating this group of patients.
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