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Dental Implant Therapy in Patients With Autoimmune Diseases: A Scoping Review
Emil Hyldahl1, Henning Schliephake2, Simon Storgård Jensen1,3
1Oral Surgery, Section for Oral Biology and Immunopathology, Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
Objectives:
The aim of this scoping review is to determine the effects of autoimmune diseases (ADs) and the agents used for treatment on dental implant survival and biologic outcomes.
Material And Methods:
An electronic database search was performed in MEDLINE (PubMed), The Cochrane Library, and Embase on 29-04-2024. Clinical studies in English on implant therapy in patients with ADs were potentially eligible. Recorded variables included study information, patient demographics, ADs, immunosuppressants, antiresorptives, dental implant survival rate, biologic complications, and oral health-related quality of life. Descriptive statistics were performed.
Results:
A total of 6319 records were retrieved through database search and hand search, of which 87 studies could be included with an overweight of case reports and retrospective studies. The available evidence was characterized by a high number of studies placed low on the hierarchy of evidence. Several outcome parameters were heterogeneously reported. Glucocorticoids were the most frequently administrated immunosuppressant. The implant survival rate was overall 85.3%-100%; hereof, 46.7%-100% of implant losses occurred early, indicating a certain risk of implant failure. Despite high implant survival in oral lichen planus (OLP) patients, one study lost 42 of 55 implants in patients with untreated flare-up of OLP.
Conclusions:
Dental implant treatment is generally predictable with a high implant survival rate, after mid-term follow-up, in patients with ADs, of whom many receive immunosuppressants. Implant losses occurred predominantly before prosthetic loading. Particularly, patients with mucosal manifestations of their ADs seem to benefit from implant-supported restorations provided mucosal lesions are well treated. However, overall low-level scientific evidence was available.
