Implant prosthodontic rehabilitation of patients with rheumatic disorders: a case series report.

PURPOSE: This retrospective study assessed implant and prosthodontic treatment outcomes of patients suffering from rheumatic disorders such as rheumatoid arthritis (RA) and connective tissue diseases (CTDs).

MATERIALS AND

METHODS

This study included 22 patients (all women) suffering from autoimmune rheumatic disorders such as isolated RA (n = 16), RA with concomitant CTDs (n = 5), or isolated CTDs (n = 1). Overall, 89 implants were placed for rehabilitations such as single-tooth replacement (n = 8), fixed partial dentures (n = 14), complete dentures (n = 5), and overdentures (n = 2), and were evaluated after a mean of 42.6 +/- 25.2 months. The cumulative implant survival and success rates and peri-implant conditions (marginal bone loss, pocket depth, Plaque Index, Gingival Index, Bleeding Index, and Calculus Index) were evaluated with a special focus on RA and CTDs. In addition, incidence and type of prosthodontic maintenance were evaluated.

RESULTS

A high implant survival rate was noted during follow-up with a cumulative 3-year implant success rate of 96.1%. Patients with RA demonstrated acceptable marginal bone resorption (mean: 2.1 +/- 0.5 mm) and good soft tissue conditions, while CTD patients showed increased bone resorption (mean: 3.1 +/- 0.7 mm). This was especially noted in scleroderma patients, as were major peri-implant soft tissue alterations (Bleeding Index) in patients suffering from Sjogren syndrome.

CONCLUSIONS

A high implant and prothodontic success rate can be anticipated even for patients suffering from autoimmune rheumatic disorders such as RA and CTDs. A scrupulous maintenance program that includes optimal oral hygiene could assist in ensuring stable long-term results for CTD patients with more vulnerable soft tissue conditions. Int J Prosthodont 2010;23:22-28.