Patient with Sarcoidosis: Candidate for Implants?
Dr. P. asks:
I have a patient with sarcoidosis. He is under treatment with corticosteroids and has active disease. I have not been able to find information in the peer reviewed dental literature concerning indications or contraindications for dental implant placement in patients with active sarcoidosis. I would be grateful for anybody who can help me with some guidance in treating this patient. Any ideas? Thanks.
Editor’s Note: Sarcoidosis, also called sarcoid (from the Greek sarx, meaning “flesh”) or Besnier-Boeck disease, is an immune system disorder characterized by non-caseating granulomas (small inflammatory nodules) or lumps of cells in various organs in the body.
4 Comments on Patient with Sarcoidosis: Candidate for Implants?
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doctorberg
11/18/2008
Also called Besnier-Boeck disease, this is mainly considered an auto inmune and as such is associated to treatment with cortico steroids and inmuno suppressants (but in the end no reliable treament), and this meds are a real complication when placing implants .This patients also develop accelerated inflamation (desregulated) and that doesnt help us either. Eventhough some patient develop frank Hypercalcemia due to vitamin D desregulation, most dont but there is a vitamin d desregulation and that affects osseointegration. This patients also develop Type IV hipersensitivity that could lead to problems with the implants and the restoations (if you consider that up to 1% of the general population is allergic to titanium).
Since most patients overcome this disease in 3 to 5 years I would just wait if possible , if not get an ironclad legal waver and after advissing the patient of all the risks and possible complications, go.
best of luck
Kent Moore
11/19/2008
I agree with the previous author, and I would be very hesitant to place implants in patients who are being actively treated with systemic steroids...
Dr L
12/25/2008
I have to date, knowingly placed 2 implants in a patient with active sarcoidosis. He is not currently being treated with steroids. Although anecdotal, both implants have done well (going on 5 years). This patient was also in need of and received a minor sinus lift in order to place one of these implants.
Of course every patient must be properly selected.
Hope this helps.
Richard Hughes, DDS, FAAI
1/31/2011
I would have more concern about the possibility of long term steroid treatment.
