A Retrospective Analysis of Endosseous Dental Implant Survival in HIV Patients

Objectives: Human-Immunodeficiency Virus (HIV) is a retrovirus that compromises the immune system. Patients typically exhibit several complications such as higher risk of infections and delayed wound healing. Endosseous implants are routinely placed in HIV positive patients as a prosethetic option for missing teeth. Limited published data exists in terms of implant survival in HIV positive patients and guidelines for implant treatment. The objective of the study is to compare implant survival in HIV positive patients compared to HIV-negative patients.
Methods: A retrospective analysis of 1529 implants placed since June 2007 to Jan 2014 was conducted. Of the 1529, 544 implants were placed in HIV positive patients. Several parameters were taken into consideration such as different operators, tobacco use, diabetes, timing of implant placement, CD4 count, viral load, grafting material used and antiretroviral therapy administered. Statistical analysis was conducted.
Results: 14/544 implants failed in HIV positive patients (97% survival). 9/13 patients were active smokers and none had diabetes. CD4 count, viral load graft material and operator skill had no statistical significance on implant survival. 13/14 implants failed before loading. Furthermore, 19/ 985 implants failed (97% survival) in the control group. Of the 19 failures, 10 exhibited a history of tobacco use. None had diabetes. 18/19 failures were loaded prior to failures.
Conclusions: No significant difference was noted in implant survival. HIV positive patients exhibited early implant failure compared to control Furthermore, tobacco had a more profound effect on implant survival in HIV patients.