title: A Prospective Longitudinal Study on Implant Prosthetic Rehabilitation in Controlled HIV-Positive Patients with 1-Year Follow-Up: The Role of CD4+ Level, Smoking Habits, and Oral Hygiene.
abstract: BACKGROUND
  A recent study showed that implant-prosthetic rehabilitation in well-controlled HIV patients gave slightly worse results than in an healthy population, and failures were all linked to infection.
  
  
  OBJECTIVE
  The aim of this study was to examine the associations between the success of implant-prosthetic treatment and systemic CD4+ level, smoking habits, and oral hygiene.
  
  
  METHODS
  This mono-centric study included HIV patients with a stable disease and good oral hygiene requiring implant rehabilitation. Each patient received at least one dental implant. Prosthesis were delivered after 90 days in the upper jaw and 60 days in the lower jaw. Primary outcome measures were prosthetic failures, implant failures, peri-implant marginal bone level changes, and biological complications (peri-implantitis, pus, pain, paresthesia). The possible association with CD4 count, smoking habits, and oral hygiene was analyzed.
  
  
  RESULTS
  Sixty-eight patients received 194 implants, and 66 patients (190 implants) were followed for 1 year. No significant associations were found between CD4+ count, oral hygiene-associated variables, and any of the outcome measures. If compared with nonsmoking/light smoking patients, patients who smoked >10 cigarettes/day suffered a statistically significant greater number of implant failures (p ≤ .005), presented a comparatively higher number of peri-implantitis (p < .001), as well as a higher frequency of pus (p ≤ .007), and reported pain (p ≤ .009).
  
  
  CONCLUSIONS
  Within the limitation of the present study, placement of dental implants in HIV-positive patients with stable disease seems a reasonable treatment option, regardless of CD4+ cell count, provided that they are in a normal range. Oral hygiene variables were not influent in this group of patient following recall appointments, while HIV-positive heavy smokers (>10 cigarettes/day) demonstrated an increased risk of early implant failure, peri-implantitis, episodes of pus, and self-reported pain.
authors.affiliation: Dental School, Vita-Salute University and IRCCS San Raffaele, Milan, Italy.
authors.forename: Enrico F
authors.initials: EF
authors.lastname: Gherlone
authors.affiliation: Dental School, Vita-Salute University and IRCCS San Raffaele, Milan, Italy. paolocappare@gmail.com.
authors.forename: Paolo
authors.initials: P
authors.lastname: Capparé
authors.affiliation: Dental School, Vita-Salute University and IRCCS San Raffaele, Milan, Italy.
authors.forename: Simona
authors.initials: S
authors.lastname: Tecco
authors.affiliation: Dental School, Vita-Salute University and IRCCS San Raffaele, Milan, Italy.
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Polizzi
authors.affiliation: Faculty of Psychology, UniSR Social.Lab [Research Methods], Vita-Salute San Raffaele University, Milan, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Pantaleo
authors.affiliation: Dental School, Vita-Salute University, Milan, Italy.|Maxillofacial Surgery and Dentistry Unit, San Rocco Hospital, Ome, Brescia, Italy.
authors.forename: Giorgio
authors.initials: G
authors.lastname: Gastaldi
authors.affiliation: Dental School, Vita-Salute San Raffaele University, Milan, Italy.
authors.forename: Maria Gabriella
authors.initials: MG
authors.lastname: Grusovin
mesh_terms: D000328:Adult; D000368:Aged; D018791:CD4 Lymphocyte Count; D015921:Dental Implants; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009910:Oral Hygiene; D011446:Prospective Studies; D012907:Smoking
chemical_list: D015921:Dental Implants
keywords: AIDS; HIV; implant; implant survival; implantology; osseointegration; peri-implantitis