Patient with lupus on corticosteroids: place implants?

Are you sure it is 5g per day? Seems very high. Is she on prednisone or other steriod?

Is it 5 grammes or 5 miiligrammes ?

18 years is a lot... im sure she has more than lupus , check better with her family medical Doc about her file. however, I guess bone quality will be reduced .CbCT is a must . Antibiotic and (hygiene control) , long implants ,if possible punch technique. bone level. screw retained. gradual come back of corticosteroids after stopping. good luck

Unless the patient is insisting on the implants, if you have an alternative avoid the implants. The sites should heal, but the inflammation and pain that may result after the surgery could be difficult to manage. Unless you are very experienced refer the surgical placement. Consult with the patient's MD is the first step, even before the surgical referral.

I along same line if someone has lupus and is not on steroids would there be a negative to placing implant?

There is no absolute contraindication for corticosteroid users in Implant surgery. 5mg of prednisolone is a sustainig dose wich is prescribed in most of the autoimmune diseases after controlling them. Longer period of healing time, gentle surgery procedures, corticosteroid dose adjustment (before an after surgery according to different protocols) and antibotic thrapy should be considered.

I would be concerned about osteoporosis, the implants may not integrate. Any med that affects bone metabolism proceed cautiously with medical consultation. Be conservative with good informed consent.

Dear Dr. very recently i had a similar case,( full mouth rehab, periodontally compromised case) but the patient had sarcoidosis and he is on steroids from past 2 yrs and he may have to continue the drugs for many more years. I consulted his physician and he said you can place it but you have to take a big risk (in terms of healing, bone remodeling and if there any repair work comes in future). Your patient is on long term steroid, and in my observation many of these patients are emotionally depressed because of the long standing problem and they may not be ready to accept or excuse if something goes wrong even if its not your mistake. So its better to question yourself whether its worth to place these many implants or not. If neighboring teeth are in good condition its better to convince them for crown and bridge treatment plan or else a Cast Partial denture. In my case the patient is finally happy with the conventional set of dentures and he really appreciated the decision. These patients first priority will always be about their systemic problem, so its better to take a back seat and plan it conservatively as much as possible. Its just my opinion.