Implant therapy following liver transplantation: clinical and microbiological results after 10 years.
BACKGROUND
The number of immunocompromised patients is increasing as a consequence of successful organ transplantation. Placing dental implants in these patients has been questioned because of their increased risk for infections. The 10-year follow-up data of a 71-year-old liver transplant recipient with long-term immunosuppressive therapy is reported. Six months after liver transplantation, two interforaminal implants were inserted in the edentulous mandible, and an overdenture using non-rigid telescopic attachments was fabricated 3 months later.


METHODS
Oral clinical parameters included the modified plaque index, sulcus fluid flow rate, modified bleeding index, probing depth, distance implant mucosa, attachment level, width of the keratinized mucosa and mobility values. The distance implant bone (DIB) was determined on digital panoramic radiographs. The levels of eight periodontal marker organisms were established using DNA probe technology. Additionally, swabs of the edentulous oral mucosa were taken for microbiological culture and antimicrobial resistance testing.


RESULTS
The peri-implant parameters were within normal ranges indicating a stable osseointegration with moderate vertical bone loss. Actinobacillus actinomycetemcomitans, Tannerella forsythensis, Campylobacter rectus, and Treponema denticola were not detected. Low levels of Porphyromonas gingivalis, Fusobacterium nucleatum, and Eikenella corrodens were found. Prevotella intermedia was the only bacterium with a level higher than 10(4). The mucosal swabs indicated the presence of an abundant normal oral flora, including Escherichia coli and Candida albicans. The antibiogram revealed multiple resistance to antibiotics.


CONCLUSIONS
This case report suggests that immunocompromised patients can be successfully rehabilitated with dental implants.
School of Dental Medicine, University of Erlangen-Nuremberg, Erlangen, Germany. siegfried.heckmann@rzmail.uni-erlangen.de
Siegfried Martin
SM
Heckmann
Josef Georg
JG
Heckmann
Jens Julian
JJ
Linke
Werner
W
Hohenberger
Andrea
A
Mombelli
D004269:DNA, Bacterial / Q000032:analysis; D017742:Dental Care for Chronically Ill; D003758:Dental Implantation, Endosseous; D019094:Dental Prosthesis, Implant-Supported; D003828:Denture, Overlay; D016124:Eikenella corrodens / Q000302:isolation & purification; D005260:Female; D005500:Follow-Up Studies; D016967:Fusobacterium nucleatum / Q000302:isolation & purification; D006801:Humans; D016867:Immunocompromised Host; D007575:Jaw, Edentulous / Q000534:rehabilitation*; D016031:Liver Transplantation / Q000276:immunology; D008334:Mandible / Q000601:surgery; D008875:Middle Aged; D009055:Mouth / Q000382:microbiology*; D016966:Porphyromonas gingivalis / Q000302:isolation & purification; D018713:Prevotella intermedia / Q000302:isolation & purification
D004269:DNA, Bacterial