Dental Implants in Patients With End-Stage Renal Disease: A Case Series.

Abstract

Purpose: Chronic kidney disease (CKD), a widespread health problem marked by a gradual loss of kidney function, presents unique challenges in various aspects of patient care. As such, this case series aimed to assess the feasibility of dental implants in end-stage renal disease (ESRD) patients.

Materials and methods: Parathyroid hormone (PTH) levels were measured at the time of implant placement and implant uncovering. Radiographic evaluations were performed at 7, 15, 30, 90, and 180 days after implant placement and 180 days after prosthetic rehabilitation. Bone remodeling was evaluated based on the values of radiographic marginal bone loss, measured as the distance between the implant shoulder and the marginal bone levels.

Results: Fifteen patients with ESRD received a total of 27 implants (5 in the maxilla and 22 in the mandible) installed in different regions, with a diameter of 3.75 mm, height of 8.5 mm, platform of 4.1 mm, and Morse taper connection. No correlation was found between PTH levels and primary implant stability (ρ = 0.04, p value = 0.860). PTH levels ranged from 105.1 to 1965 pg/mL (mean 613.51 ± 494.38 pg/mL). Only one implant did not demonstrate primary stability during surgery, the others ranged from 15  to 50 Ncm of stability. Seven implants failed during the evaluation due to varying degrees of bone loss. There was no significant effect of primary stability or PTH levels on implant loss.

Conclusion: Accelerated marginal bone loss within 6 months and reduced osseointegration in ESRD patients may lead to early implant loss and treatment challenges.