Avances en periodoncia; 20; 3; 165-172; 2008. Ferrús-Torres E, Piñera-Penalva M, Berini-Aytés L, Gay-Escoda C. Doctor en Medicina. Estomatólogo. Especialista en Cirugía Maxilofacial. Catedrático de Patología Quirúrgica Bucal y Maxilofacial. Director del Máster de Cirugía Bucal e Implantología Bucofacial. Facultad de Odontología de la Universidad de Barcelona. Investigador Coordinador del IDIBELL. Jefe del Servicio de Cirugía Bucal, Implantología Bucofacial y Cirugía Maxilofacial del Centro Médico Teknon. Barcelona.
The improvement in survival and quality of life of HIV-positive patients has led to a significant rise in demand for esthetic dental treatment among these patients. In this context, implant-supported prostheses are currently considered a valid treatment option. We present three HIV-positive males seen in our Service of Oral Implantology for the evaluation of possible implant-supported rehabilitation. The clinical course of the patients had remained stable for a minimum of four years. A total of 12 implants were positioned (case 1: 4 Defcon® implants, 2 in the upper maxilla and 2 in the mandible; case 2: 2 ITI® implants in the mandible; and case 3: 6 Brånemark System® implants in the upper maxilla;), all under locoregional anesthesia and applying the usual technique. No guided bone regeneration procedures were applied. There were no intraand/or postoperative complications, and no alterations in the biological parameters of background disease control following the surgical intervention. Implants have been considered a treatment option in patients of this kind, despite the fact that their long-term reliability has not been established. With the exception of two articles (respectively involving immediate singe implant placement and complete oral rehabilitation), no other study has been published on rehabilitation with implants in HIV-positive patients. Both of these articles corroborate the hypothesis that minor oral surgery does not increase the risk of locoregional infection in correctly controlled HIV-positive patients, as reflected in our three cases. In the immediate postoperative period, there were no significant variations in CD4+ cell count or in any other biological parameter, as described in the literature, with excellent soft and hard tissue healing.