02 February 2022

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Dental implants in organ transplant patients

Lara Figini

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At present, the number of patients who come to the dental clinic and who have undergone organ transplants is always increasing. In 2015, there were more than 3200 transplantations in Europe,

among which 61.46% concerned kidneys and 23.52% liver.1 A significant group of those patients requires dental rehabilitation; since in the course of preparations for the procedure, extraction

of numerous teeth is often enforced by the need to sanitize oral cavity. Many

patients live more than 20 years after transplantation procedures; consequently, the question of life quality related to appropriate functioning of their stomatognathic system is absolutely crucial. The use of titanium implants is currently considered the best method for replacing missing teeth. However, the depressing impact of immunosuppressive drugs given to patients after organ transplant until the end of their life is commonly known and well established. For many years, it has even been considered that immunosuppression is an absolute contraindication for undertaking implant treatment.

Material and methods
In a clinical study, published on Implant Dentistry, October 2019, the authors performed a functional and aesthetic evaluation of implant-prosthetic treatments in patients undergoing immunosuppressive treatment after organ transplants. The study involved a group of 21 patients on immunosuppressant therapy after transplant procedures. A total of 24 implants were placed in this experimental group. The control group included 15 subjects with 15 implants placed. The research protocol involved replacing a single missing tooth with a titanium implant. After 4 months, prosthetic rehabilitation with single crowns was carried out. After 24 months the preliminary treatment evaluation was performed. The main parameter calculated was the crestal bone level (CBL). A mechanical evaluation and objective measurement of the implant stability was also performed.

Results
The median measurement of CBL crestal bone level in the experimental and control groups was found to be 0.325 mm (min 0 - max 0.95) and 0.5 mm (min 0.15 - max 1.8), respectively. Comparison of the CBL medians revealed a lack of significant differences between the experimental and control groups (P ¼ 0.089).

Conclusions
From the data of this study, which must be confirmed in other similar studies, it can be concluded that patients with organ transplants can safely and effectively undergo dental implant treatment.

Clinical implications
The results of this study should become a significant contribution to further research of the group of patients submitted to immunosuppressive treatment, also for reasons other than transplantation. The subsequent acquisition and confirmation of comparable results among those people as well shall give opportunity to improve life quality of a vast group of patients.

For additional information: Osseointegration of Dental Implants in Organ Transplant Patients Undergoing Chronic Immunosuppressive Therapy