Tissue level implants in healthy versus medically compromised patients: a cohort comparative study

Dental implants placed in medically compromised patients have predictable outcomes and a high rate of survival, compared to those placed in healthy patients. The aims of this study were to observe and compare implant survival/success rates and soft tissue response to tissue-level implants placed in healthy and medically compromised patients with a 1-year follow-up.

Seventy-two patients, 36 healthy patients (20 females and 16 males) and 36 medically compromised patients (18 females and 18 males) affected by cardiovascular diseases (arrythmia, hypertension, atrial fibrillation, bypass and pacemaker surgery), depression, endocrine metabolic diseases (hypercholesterolemia, type II diabetes, Hashimoto's thyroiditis), gastrointestinal diseases (gastritis, hiatal hernia, gastric ulcers), asthma, osteoporosis or glaucoma received one tissue-level implant. Measurements for primary and secondary outcomes were collected immediately after implant placement and at 1 year from implant insertion.

Three were failed and two were survived out of a total of 72 implants. Among healthy patients, two implants failed while one was classified as survived; among Medically compromised patients one implant failed and another one was classified as survived. No statistically significant difference was found between the two groups in terms of success rate or survival rate. No statistically significant differences between the two groups' marginal bone level was observed. In healthy patients a mean loss of keratinized tissue (-0.1±0.6 mm) was reported, while in medically compromised patients a mean gain was reported (+0.5±0.8 mm).

In terms of success, failure and survival rates, tissue level implants placed in healthy and in medically compromised individuals showed no short-term (1 year) differences.