Implant-prosthetic treatment in HIV-infected patients receiving highly active antiretroviral therapy: report of cases.
OBJECTIVE
Since 1997, the use of highly active antiretroviral therapy (HAART) has significantly improved systemic health and life expectancy of patients who test positive for the human immunodeficiency virus (HIV) in industrialized countries. Therefore, although implant-supported prosthetic rehabilitation has been restricted to immunocompetent individuals, it may be considered for these patients.


METHODS
The treatment course of implant-prosthetic rehabilitation in 3 patients is reported. Patient 1 (male, age 64 years) was under 4-drug therapy; patient 2 (male, age 38 years) and patient 3 (female, age 49 years) were under 3-drug therapy. Two patients had suffered from AIDS-defining diseases prior to HAART. Oral manifestations of HIV infection were not diagnosed throughout the observation period. Patients had CD4+ cell counts between 250 and 800/mL, and viral load was below 50/mL. Perioperative antibiotic treatment was not applied. Two patients presented with edentulous mandibles. In the third patient, single-tooth replacement of both mandibular first molars was performed. A total of 10 Frialit-2 implants were placed without augmentation procedures.


RESULTS
One implant failed after 3 months and was successfully replaced. Two patients received magnet-retained overdentures in the mandible, and 1 patient was treated with single crowns. All implants and restorations are successfully in function. Neither radiographic nor clinical signs of inflammation were detected during the observation period (range, 7 to 32 months).


CONCLUSIONS
The outcomes of the 3 patients suggest that immunologically stable HIV-positive patients on HAART may be considered for implant-prosthetic rehabilitation.
Strietzel
Frank P
FP
Department of Oral Surgery and Dental Radiology, Center for Dental Medicine, Campus Virchow-Klinikum, Charité Universitätsmedizin Berlin, Germany. frank.strietzel@charite.de
Rothe
Sven
S
Reichart
Peter A
PA
Schmidt-Westhausen
Andrea-Maria
AM
D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D018791:CD4 Lymphocyte Count; D003442:Crowns; D017742:Dental Care for Chronically Ill; D015921:Dental Implants; D019250:Dental Implants, Single-Tooth; D019094:Dental Prosthesis, Implant-Supported; D019232:Dental Restoration Failure; D003826:Denture, Complete, Lower; D003828:Denture, Overlay; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000188:drug therapy*; D006801:Humans; D007575:Jaw, Edentulous / Q000534:rehabilitation / Q000601:surgery; D008297:Male; D008334:Mandible / Q000601:surgery; D008875:Middle Aged; D008963:Molar; D019233:Retreatment; D019562:Viral Load
D015921:Dental Implants