Implant Prosthetic Rehabilitation in Controlled HIV-Positive Patients: A Prospective Longitudinal Study with 1-Year Follow-Up
Implant Prosthetic Rehabilitation in Controlled HIV-Positive Patients: A Prospective Longitudinal Study with 1-Year Follow-Up
复制标题
DOI：
10.1111/cid.12353
复制
发表时间：
2016-08-01
影响因子：
3.6
通讯作者：
Grusovin, Maria Gabriella
中科院分区：
文献类型：
--
作者：
Gherlone, Enrico F.;Cappare, Paolo;Grusovin, Maria Gabriella
目的：该临床试验旨在评估受控 HIV 阳性患者的种植修复康复存活率。材料和方法：这项单中心研究包括疾病稳定、需要种植修复且口腔卫生良好的 HIV 患者。每位患者至少接受一颗种植牙。上颌 90 天、下颌 60 天后，合适的假体被交付。主要结果指标是修复体失败、种植体失败、种植体周围边缘骨水平变化（MBLC）和生物并发症（种植体周围炎、脓、疼痛、感觉异常）。记录干预前 (T0)、干预后 6 个月 (T1) 和 12 个月 (T2) 的数据。 结果：68 名患者（22 名女性和 46 名男性；194 个植入物）中植入了种植体。两名患者在随访第六个月前因疾病恶化而退出，66 名患者（190 个种植体）完成了研究。 48 名患者（70.6%）接受了全活动义齿； 11 名患者（16.2%）接受了部分假体，9 名患者（13.2%）接受了单一元件。 9 名患者（190 名患者中的 15 名）发生了种植体失败。这些是由于原发感染（190 个固定装置中的 5 个：2.6%）和种植体周围炎（190 个固定装置中的 10 个：5.2%）导致的早期种植失败。由于所有固定装置丢失，两名患者（占患者的 3%）出现假肢失败。分别有 4/7 和 3/7 的种植体周围炎患者出现脓液和疼痛。未发现固定装置断裂或感觉异常。在 T2 时，平均种植体周围 MBLC 为 -1.19 +/- 0.87 mm。 结论：在其局限性范围内，该研究表明，在控制良好的 HIV 患者群体中，种植体康复可能是一个合适的选择，但结果略差于正常人群中获得的结果。前六个月种植体周围感染的发生率较高，表明需要适当的感染控制方案。
Purpose: The clinical trial aimed to evaluate the survival of implant-prosthetic rehabilitation in controlled HIV-positive patients.Materials and Methods: This mono-centric study included HIV patients with a stable disease, requiring implant rehabilitation, with good oral hygiene. Each patient received at least one dental implant. After 90 days in the upper jaw and 60 days in the lower jaw, the appropriate prosthesis was delivered. Primary outcome measures were prosthetic failures, implant failures, peri-implant marginal bone level changes (MBLCs), and biological complications (peri-implantitis, pus, pain, paresthesia). Data were recorded before the intervention (T0), and 6 (T1) and 12 months (T2) after.Results: Implants were positioned in 68 patients (22 females and 46 males; 194 implants). Two dropouts occurred for exacerbation of the disease before the sixth month of follow-up, and 66 patients (with 190 implants) completed the study. Forty-eight patients (70.6%) received total removable dentures; 11 patients (16.2%) received partial prosthesis, and nine patients (13.2%) received single elements. Implant failure occurred in nine patients (15 fixtures out of 190). These were early implant failures due to primary infection (five fixtures out of 190: 2.6%) and to peri-implantitis (10 fixtures out of 190: 5.2%). Prosthetic failure was registered in two patients (3% of patients) due to the loss of all the fixtures. Pus and pain were observed in 4/7 and 3/7 patients with peri-implantitis, respectively. No fractures of fixtures or paresthesia were registered. At T2, the mean peri-implant MBLC was -1.19 +/- 0.87 mm.Conclusions: Within its limitations, the study showed that in a well-controlled population of HIV patients implant rehabilitation can be a suitable options with results slightly worse to those obtained in normal population. A higher incidence of peri implant infections in the first six months was present pointing to the need of a proper protocol for infection control.