Implant prosthetic rehabilitation in controlled HIV-positive patients: A proscpective longitudinal study with one-year follow-up

Aim. This prospective longitudinal clinical trial aim
ed to evaluate survival of implantprosthetic
rehabilitation
in controlled HIV-positive patients.
Methods. This mono-centric study (IRCCS San Raffaele
Hospital in Milan, Italy) included Hiv-patients with
a stable disease, requiring implant rehabilitation (total or
partial), with good oral hygiene. Each patient received
at least one dental implant. After 90 days in the upper
jaw and 60 days in the lower jaw, the appropriate prosthesis
was delivered. One year follow-up after implant
insertion was considered. Survival criteria for implant
are presence of implant stability, absence of radiolucent
zone around the implants, no mucosal suppuration, and
no pain. (Buser e Albrektsson). Primary outcome measures
were prosthetic failures, implant failures, peri-implant marginal bone level changes (MBLC) and biological
and prosthetic complications (perimplantitis, pus,
pain, paresthesia in the lower jaw, implant fracture).
Data were recorded immediately after the insertion of
the fixture (T0), and 6 (T1) and 12 months (T2) after.
Results. Implants were positioned in 68 patients (22
females and 46 males) (194 implants). Two drop outs
occurred for exacerbation of the disease before the six
month of follow-up, and 66 patients (with 190 implants)
completed the study. Forty-eight patients (70.6%) received
total removable dentures (among them 30 subjects
received the upper dental arch, and 18 patients
received the lower dental arch); 11 patients (16.2%) received
partial prosthesis and 9 patients (13.2%) received
single elements rehabilitations. Implant failure occurred
in 9 patients (15 fixtures out of 190). They were early
implant failures due to primary infection (5 fixtures out
of 190: 2.6%) and to perimplantitis (10 fixtures out of
190: 5.2%). Prosthetic failure was registered in 2 patients
(3% of patients) due to the loss of all the fixtures.
Pus and pain were observed in 4/7 and 3/7 patients
with perimplantitis, respectively. In three patients with
serious perimplantitis, pus and pain were observed together.
No fractures of fixtures or paresthesia were registered.
At T2, in 66 patient with 190 fixtures, the mean
perimplant MBLC was -1.19±0.87 mm.
Conclusion. Within its limitations, the study showed
that in a well-controlled population of HIV patients who
maintained proper oral hygiene and accepted to follow
a proper professional maintenance protocol, implant rehabilitation
can be a suitable options with results. slightly
worse to those obtained in normal population. An
higher incidence of peri-implant infections in the first six
months, probably linked to immunological conditions,
was present pointing to the need of a proper protocol
for infection control.