title: The success of endosseous implants in human immunodeficiency virus-positive patients receiving antiretroviral therapy: a pilot study.
abstract: BACKGROUND
  In a pilot study, the authors aimed to determine the success rate of dental implants placed in patients who were positive for human immunodeficiency virus (HIV) and were receiving different regimens of highly active anti-retroviral therapy (HAART). They considered patients' levels of cluster of differentiation (CD) 4(+) cells and viral load, and they attempted to verify whether patients with baseline biochemical signs of bone mineral density loss could experience osseointegration impairment.
  
  
  METHODS
  One of the authors, a dentist, placed dental implants in the posterior mandibles of 40 volunteers, divided into three groups: one composed of HIV-positive patients receiving protease inhibitor (PI)-based HAART; a second composed of HIV-positive patients receiving nonnucleoside reverse transcriptase inhibitor-based HAART (without PI); and a control group composed of HIV-negative participants. The authors assessed peri-implant health six and 12 months after implant loading. They analyzed the success of the implants in relation to CD4(+) cell counts, viral load and baseline pyridinoline and deoxypyridinoline values.
  
  
  RESULTS
  The authors followed 59 implants for 12 months after loading. Higher baseline levels of pyridinoline and deoxypyridinoline found in HIV-positive participants did not interfere with osseointegration after 12 months of follow-up. Average peri-implant bone loss after 12 months was 0.49 millimeters in group 1, 0.47 mm in group 2 and 0.55 mm in the control group.
  
  
  CONCLUSIONS
  The placement of dental implants in HIV-positive patients is a reasonable treatment option, regardless of CD4(+) cell count, viral load levels and type of antiretroviral therapy. Longer follow-up periods are necessary to ascertain the predictability of the long-term success of dental implants in these patients.
  
  
  CONCLUSIONS
  Limited published scientific evidence is available to guide clinicians in regard to possible increased risks associated with dental implant placement in HIV-positive patients.
authors: Department of Oral Pathology, School of Dentistry, University of São Paulo, Avenida Professor Lineu Prestes 2227, Cidade Universitária, 05508-000, São Paulo, São Paulo, Brazil. maocape@usp.br
authors: Marcio A
authors: MA
authors: Oliveira
authors: Marina
authors: M
authors: Gallottini
authors: Débora
authors: D
authors: Pallos
authors: Paulo S Z
authors: PS
authors: Maluf
authors: Fernando
authors: F
authors: Jablonka
authors: Karem L
authors: KL
authors: Ortega
mesh_terms: D000328:Adult; D016301:Alveolar Bone Loss / Q000145:classification; D000539:Alveolar Process / Q000000981:diagnostic imaging; D000596:Amino Acids / Q000032:analysis; D019380:Anti-HIV Agents / Q000627:therapeutic use; D023241:Antiretroviral Therapy, Highly Active / Q000145:classification*; D015415:Biomarkers / Q000032:analysis; D015519:Bone Density / Q000502:physiology; D018791:CD4 Lymphocyte Count; D003758:Dental Implantation, Endosseous; D015921:Dental Implants; D005260:Female; D005500:Follow-Up Studies; D006678:HIV / Q000302:isolation & purification; D018023:HIV Seronegativity; D006679:HIV Seropositivity / Q000188:drug therapy*; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D008297:Male; D008334:Mandible / Q000000981:diagnostic imaging / Q000601:surgery; D008875:Middle Aged; D016348:Osseointegration / Q000502:physiology; D010865:Pilot Projects; D016300:Radiography, Bitewing / Q000379:methods; D018894:Reverse Transcriptase Inhibitors / Q000627:therapeutic use; D016896:Treatment Outcome; D019562:Viral Load
chemical_list: D000596:Amino Acids; D019380:Anti-HIV Agents; D015415:Biomarkers; D015921:Dental Implants; D018894:Reverse Transcriptase Inhibitors; C015484:pyridinoline; C036020:deoxypyridinoline