Bone mineralization and immediate function of six dental implants in patients with Klinefelter syndrome.

Missing teeth are a major problem in cleft patients, who require specialized prosthetic management, including dental implants. The aim of this review was to investigate the optimal date for implant insertion in patients born with cleft lip and palate after bone grafting and to assess the long-term prognosis of the inserted dental implants. A systematic review of the current literature electronically in several databases and additional hand searching were performed. Relevant publications were assessed with regard to their evidence according to the guidelines of the Oxford Centre for Evidence-Based Medicine. Forty-nine publications (prospective and retrospective clinical studies, case series, and case reports) were included for analysis, but only 18 clinical papers reported survival rates for dental implants (in all, 670 implants in 460 cleft patients). Most studies were evidence level 3b (case-control studies) or 4 (case series, case reports). Reported 5-year survival rates for dental implants in cleft patients ranged from 80% to 96% (mean, 88.6%). Implant placement is favored after growth is complete and is generally recommended within 4 to 6 months after bone grafting. Dental implants in patients with cleft lip and palate show high success rates and allow for sufficient oral rehabilitation. However, because of a lack of sufficient prospective clinical studies on dental implants in cleft patients, the available evidence is poor and insufficient.

Purpose: Diabetes has always been a challenge in implant treatment. The hyperglycemia present in diabetic individuals negatively affects bone healing, and with an increased risk of osteoporosis and delayed wound healing, it impacts the success rate of implants. However, implants in diabetic patients with controlled diabetes have a high success rate similar to that of non-diabetic individuals. This study aims to determine the success rate of dental implants in patients with type 2 diabetes. Materials and Methods: Based on PRISMA guidelines, this systematic review included 23 articles, comprising ten articles from the PubMed database and 13 articles from the Google Scholar database. The search strategy included terms related to dental implants in diabetic patients, and the performance of articles was examined systematically. Results: Overall, the success rate of dental implants in individuals with type 2 diabetes in the articles included in this study was 93.67%, and the failure rate was 6.33%. Specifically, the average HbA1c was 7.26%, the average age was 52.41 years, the average number of implants was 1.91, and the duration of diabetes in individuals included in this study was 7.46 years. Therefore, factors such as HbA1c, age, number of implants, duration of diabetes, and blood sugar control (whether controlled or uncontrolled) are reasons for the similarities and differences in the success rate of implants in patients with type 2 diabetes. An increase in these factors leads to a higher rate of dental implant failure in these individuals (due to delayed wound healing, weakened immune system, and increased susceptibility to osteoporosis and infections). While the first three factors were reasons for the differences in implant success rates between diabetic and non-diabetic groups, the success rate for non-diabetic individuals included in this study was 98.68%, and the failure rate was 1.32%. The average HbA1c was about 5.39%, the average age was 49.98 years, and the average number of implants was 1.63. Conclusion: In conclusion, this systematic review aimed to determine the success rate of dental implants in patients with type 2 diabetes. Our findings indicate that dental implants in patients with controlled type 2 diabetes have a high success rate similar to non-diabetic patients. However, in patients with poorly controlled diabetes, the success rate decreases significantly. Therefore, the controlled blood sugar, HbA1c level, age, number of implants and the duration of diabetes are crucial factors in achieving a high success rate in diabetic patients.

To map and synthesize the available evidence on oral rehabilitation using dental implants in edentulous patients with epidermolysis bullosa (EB), describing clinical approaches, reported outcomes in the literature, and existing gaps in knowledge. A scoping review was conducted on March 26, 2025, following the PRISMA-ScR guidelines. Searches were made in the following databases: Cochrane Library, Embase, Google Scholar, Handbook, LILACS, PubMed/MEDLINE, SciELO, Scopus, and Web of Science. The PCC framework was applied, considering adult patients with EB (Population), oral rehabilitation with dental implants (Concept), and published clinical evidence on implant-supported rehabilitation (Context). Eligible study designs included case reports, case series, retrospective studies, prospective studies, and cohort studies. Exclusion criteria included reviews and protocols, publications not written in English, Spanish, or Portuguese, studies addressing oral mucosal lesions in a broad, and unavailable full texts. Descriptive statistics (frequencies and percentages) were used to synthesize and present the main characteristics of the included studies. Risk of bias was assessed using the appropriate JBI Critical Appraisal Checklists. A total of 226 records were identified; after duplicate removal and screening, 16 studies met the inclusion criteria and were included in the review. All selected studies were published between 2000 and 2021. The included studies reported a total of 311 implants placed, with a low failure rate of 2.25% in patients with EB. The most frequently reported challenges in implant rehabilitation were microstomia, ankyloglossia, and vestibule obliteration. Several intraoperative precautions were recommended, such as tissue lubrication, deep and slow injection of anesthetic into the soft tissues, and the use of the minimum necessary irrigation. Oral rehabilitation with dental implants constitutes a safe and effective therapeutic approach for individuals with epidermolysis bullosa, providing functional and nutritional benefits while minimizing oral mucosal trauma. Despite the low reported implant failure rates and high patient satisfaction, long-term clinical studies are still needed to confirm the survival of these outcomes. Comprehensive preventive and maintenance care remains essential throughout all stages of the rehabilitation process.

Bone remodeling identifies the process of permanent bone change with new bone formation and old bone resorption. Understanding this process is essential in many applications, such as optimizing the treatment of diseases like osteoporosis, maintaining bone density in long-term periods of disuse, or assessing the long-term evolution of the bone surrounding prostheses after implantation. A particular case of study is the bone remodeling process after dental implantation. Despite the overall success of this type of implants, the increasing life expectancy in developed countries has boosted the demand for dental implants in patients with osteoporosis. Although several studies demonstrate a high success rate of dental implants in osteoporotic patients, it is also known that the healing time and the failure rate increase, necessitating the adoption of pharmacological measures to improve bone quality in those patients. However, the general efficacy of these antiresorptive drugs for osteoporotic patients is still controversial, requiring more experimental and clinical studies. In this work, we investigate the effect of different doses of several drugs, used nowadays in osteoporotic patients, on the evolution of bone density after dental implantation. With this aim, we use a pharmacokinetic–pharmacodynamic (PK/PD) mathematical model that includes the effect of antiresorptive drugs on the RANK/RANK-L/OPG pathway, as well as the mechano-chemical coupling with external mechanical loads. This mechano-PK/PD model is then used to analyze the evolution of bone in normal and osteoporotic mandibles after dental implantation with different drug dosages. We show that using antiresorptive agents such as bisphosphonates or denosumab increases bone density and the associated mechanical properties, but at the same time, it also increases bone brittleness. We conclude that, despite the many limitations of these very complex models, the one presented here is capable of predicting qualitatively the evolution of some of the main biological and chemical variables associated with the process of bone remodeling in patients receiving drugs for osteoporosis, so it could be used to optimize dental implant design and coating for osteoporotic patients, as well as the drug dosage protocol for patient-specific treatments.

Clinical and radiographic status around short dental implants in patients with different glycemic levels remains unexplored. To determine the clinical and radiographic bone level (RBL) around short dental implants in type-2 diabetes mellitus (T2DM), prediabetic, and non-diabetic patients. Participants were grouped into three groups based on HbA1c levels: T2DM (Group-1); prediabetic patients (Group-2); and non-diabetic subjects (Group-3). Clinical recordings included the assessment of peri-implant plaque index (PI), bleeding on probing (BOP), probing depth (PD). Radiographic analysis included evaluation of standardized periapical digital radiographs using specialized software and image analyzer. Clinical peri-implant parameters including PI and BOP were statistically significantly higher in group-1 (P < .01) and group 2 (P < .05) as compared to group-3. Mean PD was statistically significantly higher in group-1 patients compared to group-3 (P < .01). Radiographic bone loss was significantly higher in both group-1 (P < .01) and group-2 (P < .05) patients as compared to patients in group 3. RBL showed statistically significant difference among T2DM patients even after adjusting for HbA1c, total cholesterol, and body mass index (P < .05) and statistically significant difference in prediabetic patients after adjusting for only HbA1c (P < .05). Clinical and radiographic peri-implant parameters are compromised around short dental implants in type-2 diabetes mellitus patients. Further longitudinal studies are needed to compare clinical performance of short dental implants with standard dental implants placed in patients with different glycemic level.

Background and purposeThe aim of this clinical study was to investigate the clinical long-term and patient-reported outcome of dental implants in patients with oral cancer. In addition, analysis of the influence of radiation therapy, timing of implant insertion, and augmentation procedures on implant survival was performed.Material and methodsThis retrospective study investigated the clinical outcome of 711 dental implants in 164 oral cancer patients, inserted by experienced surgeons of the Department of Oral and Maxillofacial Surgery, University Medical Center Mainz, Germany. Oral health-related quality of life (OHRQoL) was evaluated.ResultsCumulative 5-year and 10-year implant survival rates for all included implants were 87.3% and 80.0%. Implants placed straight after ablative surgery (primary implant placement) and implants placed after completing the oncologic treatment (secondary implant placement) showed a comparable implant survival (92.5% vs. 89.5%; p = 0.635). Irradiation therapy had no significant influence on implant survival of secondary placed implants (p = 0.929). However, regarding implant site (native bone vs. augmented bone) and radiation therapy (non-irradiated bone vs. irradiated bone), implants inserted in irradiated bone that received augmentation procedures showed a statistically significant lower implant survival (p < 0.001). Patients reported a distinct improvement in OHRQoL.ConclusionsPromising long-term survival rates of dental implants in patients after treatment of oral cancer were seen. In addition, patients benefit in form of an improved OHRQoL. However, bone augmentation procedures in irradiated bone may result in an impaired implants’ prognosis.

To assess the influence of systemic sclerosis (SSc) on the survival rate of dental implants in SSc patients receiving implant-supported treatments. The Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) Statement and the Cochrane Collaboration's guiding principles were followed during the study's execution. The data from three databases, PubMed, Google Scholar, and Scopus, available until January 2023, were used to compile the material for our research. Only English-language publications were submitted for this research and evaluated based on their titles, abstracts, and full texts. For performing a quality assessment, quality scores were calculated. The total number of patients and implants studied were 37 and 153, respectively, all having had scleroderma. The patients' ages ranged from 28 to 77 years old, with a mean (SD) age of 58.16 (12.88). All the patients in the case reports and most in the case series study were female. The range of follow-up duration was from 1 to 10 years. In case report studies, the survival rate was 100%; in case series, it was 89.2%. The SSc status had no discernible impact on the implant survival rate. Implant-based treatments in SSc patients should not worsen the overall morbidity and should not conflict with systemic treatments. Before starting implant therapy, a thorough risk assessment is essential, though.

It's not all about the testes: medical issues in Klinefelter patients

Saving patients by pulling their teeth out - but killing them softly afterwards with dental implants?

The present review aimed to summarize and evaluate the available literature regarding the survival rate and outcomes of dental implants in patients with Papillon-Lefèvre syndrome (PLS). An extensive search of the literature was conducted on PubMed, Scopus and Web of Science databases for all data published from January 1996 till April 2020 using a combination of the following keywords: 'Papillon Lefévre Syndrome', 'prosthodontic rehabilitation' and 'dental implant' according to the PRISMA guidelines for the focused research question constructed using the PICO criteria. Clinical trials and observational studies on implant placement in PLS patients reported in English language were included in the study. A total of 10 studies (nine case reports and one case series) comprising 124 dental implants placed in 13 PLS patients were included. The follow-up period ranged from 4 months to 9 years. With regard to implant loading, 9 studies reported delayed loading, while one study did not provide any information regarding the nature of implant loading. The design of prosthodontic superstructure was either a removable or fixed prosthesis. Out of the 124 inserted implants, 20 (16%) were reported as failed. The overall survival rate was 84%. The limited available evidence suggests that the survival rate of dental implants in patients with PLS is lower than that among healthy individuals. Nevertheless, no strict contraindication for implant-supported prosthesis seems to be justified in this group of patients. Further longitudinal studies with adequate follow-up periods are highly warranted. The prognosis of implant treatment for PLS patients has not yet been established. Dental practitioners should follow a careful approach in planning the dental implant treatment for this cohort of patients.

Background/Aim: Dental implants are a reliable treatment choice for rehabilitation of healthy patients as well as subjects with several systemic conditions. Patients with oral mucosal diseases often exhibit oral mucosal fragility and dryness, erosions, blisters, ulcers or microstomia that complicate the use of removable dentures and emphasize the need for dental implants. The aim of the current study is to review the pertinent literature regarding the dental implantation prospects for patients with oral mucosal diseases. Material and Method: The English literature was searched through PubMed and Google Scholar electronic databases with key words: dental implants, oral mucosal diseases, oral lichen planus (OLP), epidermolysis bullosa (EB), Sjögren’s syndrome (SS), cicatricial pemphigoid, bullous pemphigoid, pemphigus vulgaris, scleroderma/systemic sclerosis, lupus erythematosus, leukoplakia, oral potentially malignant disorders, oral premalignant lesions, oral cancer and oral squamous cell carcinoma (SCC). Results: Literature review revealed dental implantation in patients with OLP (14 articles), EB (11 articles), pemphigus vulgaris (1 article), SS (14 articles), systemic sclerosis (11 articles), systemic lupus erythematosus (3 articles) and oral SCC development associated with leukoplakia (5 articles). No articles regarding dental implants in patients with pemphigoid or leukoplakia without SCC development were identified. Most articles were case-reports, while only a few retrospective, prospective or observational studies were identified. Conclusions: Dental implants represent an acceptable treatment option with a high success rate in patients with chronic mucocutaneous and autoimmune diseases with oral manifestations, such as OLP, SS, EB and systemic sclerosis. Patients with oral possibly malignant disorders should be closely monitored to rule out the development of periimplant malignancy. Further studies with long follow-up, clinical and radiographic dental data are required to predict with accuracy the outcome of dental implants in patients with oral mucosal diseases.

IS SJOGREN SYNDROME A RISK FACTOR/CONTRAINDICATION FOR DENTAL IMPLANTS? AN UMBRELLA REVIEW

Spermatogonial stem cell preservation in boys with Klinefelter syndrome: to bank or not to bank, that's the question

Long-Term Survival of Dental Implants in Irradiated Patients

The aim of this comprehensive literature review is to provide recommendations and guidelines for dental implant therapy in patients with a history of radiation in the head and neck region. For the first time, a meta-analysis comparing the implant survival in irradiated and non-irradiated patients was performed. An extensive electronic search in the electronic databases of the National Library of Medicine was conducted for articles published between January 1990 and January 2013 to identify literature presenting survival data on the topic of dental implants in patients receiving radiotherapy for head and neck cancer. Review and meta-analysis were performed according to Preferred Reporting Items for Systematic Review and Meta-Analyses statement. For meta-analysis, only studies with a mean follow-up of at least 5 years were included. After screening 529 abstracts from the electronic database, we included 31 studies in qualitative and 8 in quantitative synthesis. The mean implant survival rate of all examined studies was 83 % (range, 34-100 %). Meta-analysis of the current literature (2007-2013) revealed no statistically significant difference in implant survival between non-irradiated native bone and irradiated native bone (odds ratio [OR], 1.44; confidence interval [CI], 0.67-3.1). In contrast, meta-analysis of the literature of the years 1990-2006 showed a significant difference in implant survival between non-irradiated and irradiated patients ([OR], 2.12; [CI], 1.69-2.65) with a higher implant survival in the non-irradiated bone. Meta-analysis of the implant survival regarding bone origin indicated a statistically significant higher implant survival in the irradiated native bone compared to the irradiated grafted bone ([OR], 1.82; [CI], 1.14-2.90). Within the limits of this meta-analytic approach to the literature, this study describes for the first time a comparable implant survival in non-irradiated and irradiated native bone in the current literature. Grafted bone combined with radiotherapy was identified as a negative prognostic factor on implant survival. The evolution of implant hardware and improvement of treatment strategies during the last years have affirmed dental implant-supported concepts as a valuable treatment option for patients with a history of radiation in the head and neck region.