Multiple Sclerosis : Contraindication for Implants?

Multiple Sclerosis (MS) is an inflammatory relapsing or progressive disorder of CNS white matter and is a major cause of disability in young adults. Pathologically, it is characterized by multifocal areas of demyelination, loss of oligodendrocytes, and astrogliosis but with relative preservation of axons. In MS, the body mistakenly directs antibodies and white blood cells against proteins in the myelin sheath, a fatty substance that insulates nerve fibers in the brain and spinal cord. This results in inflammation and injury to the sheath and ultimately to the nerves that it surrounds. The result may be multiple areas of scarring (sclerosis).This damage can slow or block the nerve signals that control muscle coordination, strength, sensation and vision. MS is unpredictable and varies in severity. In some people, multiple sclerosis is a mild illness, but it can lead to permanent disability in others. Treatments can modify the course of the disease and relieve symptoms. There is as yet no definitive cure for MS. Many patients do well with no therapy at all, especially since many medications have serious side effects and some carry significant risks. Beta interferon has been shown to reduce the number of exacerbations and may slow the progression of physical disability. When attacks do occur, they tend to be shorter and less severe. The FDA has approved a synthetic form of myelin basic protein, called copolymer I, for the treatment of relapsing-remitting MS, and an immunosuppressant treatment, Novantrone, for the treatment of advanced or chronic MS. The other drugs of use are; Glatiramer which is an alternative to beta interferons, Natalizumab which works by blocking the attachment of immune cells to brain blood vessels and Corticosteroids to reduce inflammation in nerve tissue and to shorten the duration of flare-ups. Those patients, who receive steroids for treatment, may bear the side effects of these kinds of drugs as well. The vast majority of patients are mildly affected, but in the worst cases, MS can render a person unable to write, speak or walk. Improving the lives of people with MS rests on better understanding of their needs and their successes and by looking into the conditions of life with MS. Maintaining the needs of MS patients, is also an essential element of measuring the effectiveness of any sort of therapeutic intervention—be it a rehabilitation process, a self-help program, or a disease-modifying therapy. A better quality of life can be offered to the patients by providing them with functional mastication and a better nutrition and might help the patients to cope with the underlying disease.

Multiple sclerosis is not a contraindication for placement of dental implants; however caution is to be exercised when planning the treatment, especially in advanced cases and cases which have had prolonged treatment with steroids.

I have one patient with MS that has 2 implants in #18,19 positions for more than 8 years. The implants are well integrated, and have stayed that way for their 8 plus years in functon. Not a scientific paper, but a successful clinical case

No contraindications other than that mentioned above but some of the Neurologists that treat M.S. patients and some patients have unfounded fears and concerns about use of dental implants or even root canals in m.s. patients.

Does anyone have experience with Socket Preservation with bone and membranes followed by implant placement?

Dr. Mandell, this is a most viable technique...R. Hughes

from my point of view , care should be taken when prescribing post operative medications . Many of ms patients are on steroids or simply immunosupressive therapy . Be aware not to icrease the dose of antiinflammatory or even the steroid -if u r using any post op- . Another thing is patient communication , sometimes they r so moody , nervous or even unstable . I have a 40 y male patient diagnosed as ms pt for about ten years . I placed some implant for him , he,s highly co-op . There is no absolute conraindication for ms patients to have implants . Thank you

Any documented reactions to semiprecious metals (those used for Porcelain fused to Metal crowns) in dentistry for MS patients? Thanks DrBenitez

Why would ever an autoimmune disease have anything to do with PFM metal framework?? MS patients are also allergic to cats, but only in the moonlight...