Prospective cohort study of dental implant success rate in patients with AIDS

Abstract

Oral health care of patients with acquired immune deficiency syndrome (AIDS) due to human immunodeficiency virus (HIV) is a growing area of concern, taking into consideration the increased life expectancy of patients resulting from antiretroviral therapy. There is insufficient literature regarding the impact of dental implants in AIDS patients. This study investigated the long-term clinical outcome of implant placement in patients diagnosed with AIDS. This monocentric study included AIDS patients with CD4 <200 cells/μL, age 18 years or older, and a minimum of one edentulous space requiring implant. All patients in the study were undergoing highly active antiretroviral therapy (HAART). HAART includes nucleoside reverse transcriptase inhibitors (NRTIs), non-nucleoside reverse transcriptase inhibitors (NNRTIs), protease inhibitors (PIs), and integrase strand transfer inhibitors (INSTIs). Typical treatment includes two different NTRIs, along with a third drug, either an INSTI, a PI, or an NNRTI. Bicon dental implants were placed in the patients after medical clearance and were followed up for 5 years. Bicon system implants were chosen because of availability and previous experience with this brand. Implant success criteria are defined as implants that had no clinical mobility at uncovering, no radiographic radiolucency, and allowed for loading and abutment placement. Implant success in AIDS patients was measured over a period of 5 years. Descriptive statistics were used. Sixteen adults met the inclusion criteria (12 males and 4 females) with mean CD4 count as 141.25 (sd 35.5). Thirty-three implants were placed in selected patients. Average time to uncovering was 151 days (sd 25 days). Two of the three failures were maxillary implants in the anterior arch, and the third was in the mandibular posterior arch. The study found a slightly higher failure rate of 10 % in patients with AIDS, compared to widely accepted failure rates in healthy patients at 5–7 %. With the advent of new medical therapies, even AIDS patients should be offered the option of root-formed implants as a viable alternative to fixed and removable prosthetics.