Immediate dental implant placement in HIV-positive patients receiving highly active antiretroviral therapy: a report of two cases and a review of the literature of implants placed in HIV-positive individuals.
BACKGROUND
There are numerous reports of oral surgical procedures in patients undergoing highly active antiretroviral therapy. In the general population, the success of immediate implant placement for replacing teeth is well documented. The number of human immunodeficiency virus (HIV)-positive patients seeking comprehensive dental care, including implant therapy, continues to increase. Aside from a solitary case report published 12 years ago, there is very limited evidence describing immediate implant placement in the HIV-positive population. The two cases described herein demonstrate successful immediate implant placement in this population.


METHODS
Two white male patients aged 48 and 55 were scheduled to undergo extraction of a mandibular premolar. Both patients were HIV-positive, receiving highly active antiretroviral therapy, and were closely monitored by their physicians. On the day of the surgical procedure, atraumatic extractions were completed, osteotomies prepared in the ideal orientation, and implants placed. The bone-to-implant gap was >1.5 mm in Case 2, which required particulate bone graft placement. Case 1 did not need additional bone grafting. In Case 1, the healing abutment was placed at the time of implant placement, whereas a second-stage surgical procedure was performed for Case 2.


RESULTS
Patients were seen at 2 and 4 weeks for postoperative assessment. No adverse postoperative sequelae were observed, and both implants integrated and were successfully restored.


CONCLUSIONS
Immediate implant placement in HIV-positive patients is a viable and successful treatment option. To our knowledge, only one other similar report exists. It is hoped that this case report adds to the body of evidence supporting immediate implant placement in the HIV-positive population.
Department of Periodontology and Dental Hygiene, School of Dentistry, University of Detroit Mercy, Detroit, MI, USA. kolhatsh@hotmail.com
Shilpa
S
Kolhatkar
Syed
S
Khalid
Anne
A
Rolecki
Monish
M
Bhola
James R
JR
Winkler
D019380:Anti-HIV Agents / Q000627:therapeutic use; D023241:Antiretroviral Therapy, Highly Active; D001641:Bicuspid; D003442:Crowns; D017742:Dental Care for Chronically Ill; D003758:Dental Implantation, Endosseous / Q000379:methods*; D019250:Dental Implants, Single-Tooth; D019094:Dental Prosthesis, Implant-Supported; D006679:HIV Seropositivity / Q000188:drug therapy; D006801:Humans; D008297:Male; D008334:Mandible; D008875:Middle Aged; D013997:Time Factors; D014081:Tooth Extraction / Q000379:methods; D020390:Tooth Socket / Q000601:surgery
D019380:Anti-HIV Agents