Dental implants in patients with rheumatoid arthritis: clinical outcome and peri-implant findings.

ABSTRACT

PURPOSE: Implant prosthodontic treatment outcomes for patients suffering from autoimmune rheumatoid arthritis (RA) with or without concomitant connective tissue diseases (CTD) were evaluated. MATERIAL AND METHODS: Thirty-four female patients' (25 isolated RA; nine RA+CTD) implant survival/success rate, peri-implant conditions (marginal bone loss, pocket depth, plaque index, gingiva index and bleeding index) and incidence of prosthodontic maintenance were retrospectively evaluated. RESULTS: Implants evaluated presented a high implant survival (100%) and a 3.5-year success (93.8%) rate during the follow-up programme (mean 47.6 month) without difference between isolated RA (94.6%) and RA and concomitant CTD (92.3%), respectively. In isolated RA, acceptable marginal bone resorption (mean 2.1 mm; SD 0.5 mm), pocket depth (mean 2.8 mm; SD3.2 mm) and healthy soft-tissue conditions (plaque/bleeding/gingiva index Grade 0 in 80%) were noticed. However, patients with RA+CTD presented increased bone resorption (mean 3.1 mm; SD 0.7 mm) and more vulnerable soft-tissue conditions (higher bleeding index) differing significantly to patients with isolated RA (p<0.01). Peri-implant parameters were significantly influenced by the patients' underlying disease (RA, RA+CTD; Kruskal-Wallis test, Jonckheere-Terpstra test). CONCLUSIONS: In contrast to isolated RA, in RA patients with concomitant CTD, differences in the peri-implant parameters such as pronounced marginal bone resorption and bleeding may be anticipated and appear to be significantly influenced by the patients' underlying disease.