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Aplastic anemia and dental implant rehabilitation: a clinical trial.

Kim JH, Shet UK, Kim BG, Kim MI, Kook MS, Oh HK, Ryu SY, Park HJ, Jung S - J Korean Assoc Oral Maxillofac Surg (2015)

Bottom Line: Excessive iron in tissue is related to clinical findings, including fibrosis, poor wound healing, and high level of angiogenesis, which are possible etiological factors of reduced osseointegration.Marginal bone did not change significantly during the follow-up period.This study suggests that dental implant procedures are a safe and reliable treatment option for restoration of missing dentition in patients with aplastic anemia.

View Article: PubMed Central - PubMed

Affiliation: Department of Oral and Maxillofacial Surgery, School of Dentistry, Chonnam National University, Gwangju, Korea.

ABSTRACT
The purpose of this study was to investigate implant-supported restoration as a technique for restoring missing teeth in patients with aplastic anemia. Recurrent bleeding from wound sites leads to persistent release of iron in the tissue. Excessive iron in tissue is related to clinical findings, including fibrosis, poor wound healing, and high level of angiogenesis, which are possible etiological factors of reduced osseointegration. A 44-year-old female patient with aplastic anemia was treated with multiple endosseous implants throughout the mandible and in the posterior region of the maxilla. After 14 implants were placed, radiological and clinical parameters were assessed during the follow-up period. Marginal bone did not change significantly during the follow-up period. The fine trabecular bone in intimate contact and enclosing the implant fixture was sufficient for successful osseointegration. None of the 14 implants were associated with compilations during the seven-year experimental period. This study suggests that dental implant procedures are a safe and reliable treatment option for restoration of missing dentition in patients with aplastic anemia.

No MeSH data available.


Related in: MedlinePlus

Photographs and radiographs of a 44-year-old female with aplastic anemia who underwent implant-supported restoration. A. Ten implants were placed in the mandible with a surgically-guided stent. B. Healing abutment connection and apically repositioned flap during the second surgery. C. Frontal view 20 months after prosthetic loading. D. Panoramic view after implant installation. Panoramic view after implant placement surgery with a few provisional implants. E. Panoramic view; final prosthesis in the mandible. Four implants were placed on each side of the posterior maxilla with sinus elevation. F. Panoramic view; seven years after implant placement surgery.
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Figure 1: Photographs and radiographs of a 44-year-old female with aplastic anemia who underwent implant-supported restoration. A. Ten implants were placed in the mandible with a surgically-guided stent. B. Healing abutment connection and apically repositioned flap during the second surgery. C. Frontal view 20 months after prosthetic loading. D. Panoramic view after implant installation. Panoramic view after implant placement surgery with a few provisional implants. E. Panoramic view; final prosthesis in the mandible. Four implants were placed on each side of the posterior maxilla with sinus elevation. F. Panoramic view; seven years after implant placement surgery.

Mentions: After five months of healing, the full mucoperiosteal flap was elevated with a midcrestal incision and two vertical releasing incisions under intravenous sedation with midazolam (0.05 mg/kg) and the local anesthesia lidocaine plus with epinephrine 1:100,000. Ten Osstem US II (Osstem Implant Co., Busan, Korea) implants were installed in the spaces left by teeth #32, #33, #34, #36, #37, #42, #43, #44, #46, and #47 (Fig. 1. A), and then provisional implants were placed in the sockets of teeth #31, #35, #41, #45.(Fig. 1. D) Primary closure of the flap involved periosteal releasing incisions, and 3-0 Vicryl (Ethicon Inc., Cornelia, GA, USA) was used as suture material.


Aplastic anemia and dental implant rehabilitation: a clinical trial.

Kim JH, Shet UK, Kim BG, Kim MI, Kook MS, Oh HK, Ryu SY, Park HJ, Jung S - J Korean Assoc Oral Maxillofac Surg (2015)

Photographs and radiographs of a 44-year-old female with aplastic anemia who underwent implant-supported restoration. A. Ten implants were placed in the mandible with a surgically-guided stent. B. Healing abutment connection and apically repositioned flap during the second surgery. C. Frontal view 20 months after prosthetic loading. D. Panoramic view after implant installation. Panoramic view after implant placement surgery with a few provisional implants. E. Panoramic view; final prosthesis in the mandible. Four implants were placed on each side of the posterior maxilla with sinus elevation. F. Panoramic view; seven years after implant placement surgery.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4641218&req=5

Figure 1: Photographs and radiographs of a 44-year-old female with aplastic anemia who underwent implant-supported restoration. A. Ten implants were placed in the mandible with a surgically-guided stent. B. Healing abutment connection and apically repositioned flap during the second surgery. C. Frontal view 20 months after prosthetic loading. D. Panoramic view after implant installation. Panoramic view after implant placement surgery with a few provisional implants. E. Panoramic view; final prosthesis in the mandible. Four implants were placed on each side of the posterior maxilla with sinus elevation. F. Panoramic view; seven years after implant placement surgery.
Mentions: After five months of healing, the full mucoperiosteal flap was elevated with a midcrestal incision and two vertical releasing incisions under intravenous sedation with midazolam (0.05 mg/kg) and the local anesthesia lidocaine plus with epinephrine 1:100,000. Ten Osstem US II (Osstem Implant Co., Busan, Korea) implants were installed in the spaces left by teeth #32, #33, #34, #36, #37, #42, #43, #44, #46, and #47 (Fig. 1. A), and then provisional implants were placed in the sockets of teeth #31, #35, #41, #45.(Fig. 1. D) Primary closure of the flap involved periosteal releasing incisions, and 3-0 Vicryl (Ethicon Inc., Cornelia, GA, USA) was used as suture material.

Bottom Line: Excessive iron in tissue is related to clinical findings, including fibrosis, poor wound healing, and high level of angiogenesis, which are possible etiological factors of reduced osseointegration.Marginal bone did not change significantly during the follow-up period.This study suggests that dental implant procedures are a safe and reliable treatment option for restoration of missing dentition in patients with aplastic anemia.

View Article: PubMed Central - PubMed

Affiliation: Department of Oral and Maxillofacial Surgery, School of Dentistry, Chonnam National University, Gwangju, Korea.

ABSTRACT
The purpose of this study was to investigate implant-supported restoration as a technique for restoring missing teeth in patients with aplastic anemia. Recurrent bleeding from wound sites leads to persistent release of iron in the tissue. Excessive iron in tissue is related to clinical findings, including fibrosis, poor wound healing, and high level of angiogenesis, which are possible etiological factors of reduced osseointegration. A 44-year-old female patient with aplastic anemia was treated with multiple endosseous implants throughout the mandible and in the posterior region of the maxilla. After 14 implants were placed, radiological and clinical parameters were assessed during the follow-up period. Marginal bone did not change significantly during the follow-up period. The fine trabecular bone in intimate contact and enclosing the implant fixture was sufficient for successful osseointegration. None of the 14 implants were associated with compilations during the seven-year experimental period. This study suggests that dental implant procedures are a safe and reliable treatment option for restoration of missing dentition in patients with aplastic anemia.

No MeSH data available.


Related in: MedlinePlus