Implant-prosthetic treatment in HIV-infected patients receiving highly active antiretroviral therapy: report of cases

PURPOSE: Since 1997, the use of highly active antiretroviral therapy (HAART) has significantly improved systemic health and life expectancy of patients who test positive for the human immunodeficiency virus (HIV) in industrialized countries. Therefore, although implant-supported prosthetic rehabilitation has been restricted to immunocompetent individuals, it may be considered for these patients. CASE REPORTS: The treatment course of implant-prosthetic rehabilitation in 3 patients is reported. Patient 1 (male, age 64 years) was under 4-drug therapy; patient 2 (male, age 38 years) and patient 3 (female, age 49 years) were under 3-drug therapy. Two patients had suffered from AIDS-defining diseases prior to HAART. Oral manifestations of HIV infection were not diagnosed throughout the observation period. Patients had CD4+ cell counts between 250 and 800/mL, and viral load was below 50/mL. Perioperative antibiotic treatment was not applied. Two patients presented with edentulous mandibles. In the third patient, single-tooth replacement of both mandibular first molars was performed. A total of 10 Frialit-2 implants were placed without augmentation procedures. RESULTS: One implant failed after 3 months and was successfully replaced. Two patients received magnet-retained overdentures in the mandible, and 1 patient was treated with single crowns. All implants and restorations are successfully in function. Neither radiographic nor clinical signs of inflammation were detected during the observation period (range, 7 to 32 months). CONCLUSIONS: The outcomes of the 3 patients suggest that immunologically stable HIV-positive patients on HAART may be considered for implant-prosthetic rehabilitation.