Patient Taking Drugs for Osteoporosis and Pulmonary Fibrosis: Can I Improve My Chances for Successful Implant Placement?
Dr. BT asks:
I have a female patient who I have treatment planned for an implant in her #8 site [maxillary right central incisor; 11]. She has osteoporosis and has been taking strontium ranelate (Protelos) which she discontinued 3 months prior. She also has pulmonary fibrosis and is taking systemic steroids and immunosuppressant drugs. I believe the immune-suppressants reduce B and T lymphocytes. I also believe that the combination on systemic steroids and immune-suppressants will decrease the chances for successful osseointegration. Is there anything I can do to improve the chances of success of my implant placement?
6 Comments on Patient Taking Drugs for Osteoporosis and Pulmonary Fibrosis: Can I Improve My Chances for Successful Implant Placement?
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sb oral surgeon
5/31/2010
I would not place an implant in any patient who is actively taking immuno-suppressants.
I would talk to this patients doctors, most likely a pulmonologist and rhuematologist, they would probably agree to avoid elective implantation of anything!!!
This patient is also on chronic steroids. This is not an absolute contra-indication for implants, but your patient has two strikes against them.
sb oral surgeon
6/1/2010
When dealing with dental implants, we must remember that patient selection is very important.
As I said above, this patient has two medical strikes against them, by the way each strike (chronic disease requiring immuno-suppressants and chronic steroid use) used to be absolute contra-indications for dental implants.
Now you are dealing with an anterior site on a woman.
Strike three, your out.
You may get away with it, but not worth the risk.
BTW, what kind of immuno-suppressants is she taking??
Dr.Roberto Rovelli
6/1/2010
Dear Colleagues,I'm an Italian Dentist,graduated first in General
Medicine(Milano State University)and after in Dentistry(Geneva University):I'd like to propose you this question about Endopore Canadian Implants:it's about 3 years I'm putting them, but I find a really big difference between the official succes rate declared and my personal success rate.My question is:that'se me who needs a better training or I'm in a big company of unsatisfied fellows?Sincerely yours,Dr.Roberto Rovelli,Milano,Italy.
T.M.Grossman DMD
6/2/2010
Dear Dr. Rovelli.....I terminated placement of the Endopore implant after using it for 7 years. If the beads become exposed, it is difficult to rescue the implant since bead removal is technically difficult. There have been numerous cases of blow outs, where a large area of bone loss occured around the implant, not necessarily at the ridge crest, 5-6 years after successful integration & function.
Sincerely
T.Grossman DMD
www.Fortlauderdaleoralsurgery.com
barry tibbott
6/8/2010
thanks sb. I had delayed consideration of implants for the foreseeable future but it is good to get more ideas and thoughts from other colleagues. She is on Thyroxin, Prednisolone 6-10mg a day and Azathoprine 150mg a day. All in all far from an ideal candidate!
From Dr BT
chintan
9/14/2010
dear sir
mu mother is suffering from fibrocis is there any chance of curing this disease she is taking steriods since 3.5years and she is alsoo suffering from asthama so kindly send me the details for curing this disease
