Medical Complications in Dental Implantology

In the patient with systemic disease, risk stratification must be undertaken for each patient assessing the risks of the surgery and ability of the patient to maintain the planned implant supported prosthesis. Any systemic disease that results in delayed wound healing can affect implant healing and lead to implant failure. Current evidence supports high implant survival rates in most patients with systemic diseases when co-risk factors which include smoking, periodontitis, and poor oral hygiene are removed. Evidence does support a higher implant failure and incidence of peri-implantitis in patients having received radiation therapy for head and neck cancer, high doses of anti-resorptive therapy for osteoporosis, multiple myeloma or metastatic cancer to the skeleton and poorly controlled diabetics. Heavy alcohol consumption also appears to lead to a higher implant failure rate. A thorough medical history, knowledge of the patients’ medications and schedule, optimization of the patient for the surgery, consulting with the patient’s medical providers, and assuring the patient understands when there are increased risks and the absolute need of excellent oral hygiene can lead to implant healing and similar high survival rates that are seen in healthy patients.