Short-term success of osseointegrated dental implants in HIV-positive individuals: a prospective study.

PURPOSE: Except for the occasional case report, there are no studies evaluating the success rate of osseointegrated dental implants in individuals infected with the human immunodeficiency virus (HIV). This study investigated the short-term clinical outcome of implant placement in a group of HIV-positive and HIV-negative individuals who required complete dentures. METHODS AND MATERIALS: Edentulous subjects were recruited from an HIV-dedicated clinic and a dental school clinic. Two BioHorizons dental implants were placed in the anterior mandible to support an overdenture opposing a maxillary denture. Outcome measurements obtained six months after activation of implants were presence of pain, mobility, soft tissue status, and radiographic bone level. Descriptive statistics were used. RESULTS: Twenty-nine edentulous adults, including 20 HIV-positive subjects (test) and nine HIV-negative subjects (control), participated. The test group had six females, 14 males; 13 Whites, four African-Americans, and three Hispanics with a mean age of 48.9 years (range: 35-59). The mean CD4 count was 467 cells/mm3 (range: 132-948). The control group had six females, three males; seven Whites, and two Hispanics with a mean age of 65.3 years (range: 50-82). Short-term success rate was 100% for both groups. No difference in clinical outcome was found between the groups. CONCLUSION: This study demonstrated dental implants are well tolerated and have predictable outcomes for HIV-infected individuals for the duration of the study and probably over an even longer term.

The effect of complete dentures with a metal palate on candida species growth in HIV-infected patients.

PURPOSE: This in vivo investigation compared the oral candidal population between heat-cured acrylic resin and nickel-chromium-beryllium alloy in maxillary complete dentures in HIV-infected patients. MATERIALS AND METHODS: Split-palate maxillary complete dentures were fabricated for 19 HIV-infected patients: one-half of the palate was made in acrylic resin and the other half in nickel-chromium-beryllium. Patients were divided into low or high CD4+ lymphocyte count groups. Dentures were worn for 5 months. Palatal mucosa was clinically evaluated at baseline, 1, 3, and 5 months after denture insertion. Specimens were collected at 1, 3, and 5 months using a modified imprint culture method. Speciation of Candida was performed using a chromogenic culture medium. Two-sample t-test was employed to determine effects and significant interactions between the control and test groups and the low and high CD4+ lymphocyte groups. A chi(2) test analyzed and compared the results of the clinical evaluation (p < 0.05). RESULTS: Significant differences were observed in the colony counts between both materials during the third (p= 0.046) and fifth months (p= 0.039). The low CD4+ group demonstrated significant differences during the third (p= 0.03) and fifth months (p= 0.05). There were no significant differences between the species of Candida that colonized either material with the exception of Candida dubliniensis (p < 0.001) and "Others" (p < 0.001) during the first and fifth months. There were no significant differences on the clinical appearance of the palatal mucosa between both materials (p= 1.00). CONCLUSIONS: The metal base proved to be effective in decreasing the fungal growth typically present in complete dentures. Although overt clinical manifestations were not present, colony counts of Candida species were high in the acrylic resin denture bases of these patients. This investigation demonstrated that metal base complete dentures provide an important alternative dental service for edentulous HIV-positive and other patients who are particularly prone to higher incidences of fungal infections.