Dental Implant Therapy in Patients With Autoimmune Diseases: A Scoping Review.

IF 4.8 1区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE
Emil Hyldahl, Henning Schliephake, Simon Storgård Jensen
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Abstract

Objectives: The aim of this scoping review is to determine the effects of autoimmune diseases (ADs) and the agents used for treatment on dental implant survival and biologic outcomes.

Material and methods: An electronic database search was performed in MEDLINE (PubMed), The Cochrane Library, and Embase on 29-04-2024. Clinical studies in English on implant therapy in patients with ADs were potentially eligible. Recorded variables included study information, patient demographics, ADs, immunosuppressants, antiresorptives, dental implant survival rate, biologic complications, and oral health-related quality of life. Descriptive statistics were performed.

Results: A total of 6319 records were retrieved through database search and hand search, of which 87 studies could be included with an overweight of case reports and retrospective studies. The available evidence was characterized by a high number of studies placed low on the hierarchy of evidence. Several outcome parameters were heterogeneously reported. Glucocorticoids were the most frequently administrated immunosuppressant. The implant survival rate was overall 85.3%-100%; hereof, 46.7%-100% of implant losses occurred early, indicating a certain risk of implant failure. Despite high implant survival in oral lichen planus (OLP) patients, one study lost 42 of 55 implants in patients with untreated flare-up of OLP.

Conclusions: Dental implant treatment is generally predictable with a high implant survival rate, after mid-term follow-up, in patients with ADs, of whom many receive immunosuppressants. Implant losses occurred predominantly before prosthetic loading. Particularly, patients with mucosal manifestations of their ADs seem to benefit from implant-supported restorations provided mucosal lesions are well treated. However, overall low-level scientific evidence was available.

目的本范围综述旨在确定自身免疫性疾病(ADs)和用于治疗的药物对牙科植入物存活率和生物学结果的影响:于 29-04-2024 年在 MEDLINE (PubMed)、The Cochrane Library 和 Embase 中进行了电子数据库检索。符合条件的可能是有关 AD 患者种植治疗的英文临床研究。记录的变量包括研究信息、患者人口统计学特征、AD、免疫抑制剂、抗骨吸收剂、牙种植体存活率、生物并发症以及口腔健康相关的生活质量。结果通过数据库搜索和人工搜索,共检索到 6319 条记录,其中 87 项研究可以纳入,病例报告和回顾性研究的比例过高。现有证据的特点是大量研究的证据等级较低。一些结果参数的报告存在异质性。糖皮质激素是最常用的免疫抑制剂。种植体存活率总体为 85.3%-100%;其中,46.7%-100% 的种植体损失发生在早期,表明存在一定的种植失败风险。尽管口腔扁平苔藓(OLP)患者的种植体存活率很高,但一项研究发现,在 55 个种植体中,有 42 个因 OLP 复发而未经治疗而丢失:结论:一般来说,AD 患者的种植牙治疗是可以预测的,经过中期随访,种植体的存活率很高,其中许多患者接受了免疫抑制剂治疗。种植体脱落主要发生在修复体植入之前。尤其是有粘膜表现的 AD 患者,如果粘膜病变得到很好的治疗,似乎可以从种植体支持的修复体中获益。不过,目前所获得的科学证据总体水平较低。
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来源期刊
Clinical Oral Implants Research
Clinical Oral Implants Research 医学-工程:生物医学
CiteScore
7.70
自引率
11.60%
发文量
149
审稿时长
3 months
期刊介绍: Clinical Oral Implants Research conveys scientific progress in the field of implant dentistry and its related areas to clinicians, teachers and researchers concerned with the application of this information for the benefit of patients in need of oral implants. The journal addresses itself to clinicians, general practitioners, periodontists, oral and maxillofacial surgeons and prosthodontists, as well as to teachers, academicians and scholars involved in the education of professionals and in the scientific promotion of the field of implant dentistry.
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