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\n\t Acquired immunodeficiency syndrome (AIDS) is the last stage of HIV infection. The body’s ability to resist infections and diseases is rapidly declining, which affects organs and systems. Until recently, implantation in HIV was considered impossible. The emergence of one-stage minimally invasive techniques has made it possible to implant implants in people with severe chronic pathologies, including HIV and AIDS. Even patients diagnosed with immunodeficiency or hepatitis can be successfully implanted with the RUTT implant.<\/p>\n

\n <\/p>\n

Whether implants can be used with HIV<\/h2>\n

\n\t The human immunodeficiency virus (HIV) gradually destroys the immune system, using its resources to replicate new viral particles. At a certain point, the body’s resistance decreases to a critical point. An HIV-infected patient develops severe diseases that are rare in people with normal immunity. These are called opportunistic or AIDS-associated diseases.<\/p>\n

\n\t Implantation is a surgical intervention that requires forces for tissue healing and resistance to bacterial processes in the oral cavity. In immunodeficiency conditions, the probability of postoperative complications, rejection of the artificial root increases.<\/p>\n

\n\t Not so long ago, HIV infection was a contraindication to implant placement. With the advent of one-stage techniques, the list of contraindications has been reduced – immunodeficiency is no longer an obstacle to surgery.<\/p>\n

In what cases implantation is possible<\/h2>\n

\n\t Preparation for implantation involves a comprehensive examination, including a number of blood tests, including CD4-lymphocyte count and viral load. These are two tests that determine how many copies of HIV are in the patient’s blood and the state of the immune system.<\/p>\n

\n\t Implantation is performed when the CD4 cell count is relatively high and there are no unfavorable symptoms.<\/p>\n

\n
• If the CD4-lymphocyte count is greater than 500, the risk of complications is the same as in patients without immunodeficiency.<\/li>\n
• If the CD4-cell count is 450-400, there is an increased chance of implant rejection, but surgery can be done.<\/li>\n
• At a level of 300 and below, surgery is postponed, antiretroviral therapy is continued until stable values are achieved.<\/li>\n<\/ul>\n

  \n\t The doctor plans treatment on an individual basis. It is possible that he will recommend retesting or waiting with the operation until the indicators are restored to normal levels.<\/p>\n

  In which cases it is not possible to place dental implants<\/h2>\n

  \n\t If the level of CD4-lymphocytes is below 350 implantation is not carried out. Immunodeficiency states are accompanied by a violation of tissue regeneration. With a sharply reduced IC, there is a high risk of fungal and bacterial microflora sprouting along the implant. I.e. the probability of peri-implantitis, implant rejection increases.<\/p>\n

  \n If the patient, in addition to HIV infection, has additional diseases related to contraindications, installation of implants becomes impossible.<\/strong><\/p>\n

  \n\t With pathologies included in the list of relative contraindications, the operation is postponed for a more favorable period.<\/p>\n

  Absolute contraindications<\/h3>\n

  \n
  • Decompensated diabetes mellitus;<\/li>\n
  • severe cardiovascular pathologies;<\/li>\n
  • open form of tuberculosis;<\/li>\n
  • diseases of blood and hematopoiesis;<\/li>\n
  • oncology;<\/li>\n
  • condition after radiation, chemotherapy;<\/li>\n
  • allergy to anesthesia;<\/li>\n
  • systemic pathologies (lupus erythematosus, aphthous stomatitis, etc.);<\/li>\n
  • certain CNS diseases (neuroses, psychoses, dementia, schizophrenia, paranoia);<\/li>\n
  • severe forms of hypo- and hyperthyroidism, adrenal and pituitary pathologies;<\/li>\n
  • connective tissue lesions with manifestations in the maxillofacial zone;<\/li>\n
  • bone tissue pathologies (dysplasias, osteopathy, osteoporosis, osteonecrosis);<\/li>\n
  • metal intolerance.<\/li>\n<\/ul>\n

    Relative contraindications<\/h3>\n

    \n
    • Diseases of the temporomandibular joint;<\/li>\n
    • increased erosion of tooth enamel;<\/li>\n
    • bite abnormalities;<\/li>\n
    • arthrozoatritis;<\/li>\n
    • bruxism;<\/li>\n
    • smoking abuse;<\/li>\n
    • past drug use;<\/li>\n
    • venereal diseases;<\/li>\n
    • un-sanitized oral cavity – caries, gingivitis, periodontitis, periodontal disease;<\/li>\n
    • poor oral hygiene;<\/li>\n
    • pregnancy, lactation.<\/li>\n<\/ul>\n

      Whether HIV status alone can always lead to implant failures<\/h2>\n

      \n\t Rejection of dental implants is<\/strong> possible due to various reasons, the HIV status of the patient is in the penultimate place<\/strong>. The main causes of artificial root rejection are:<\/p>\n

      \n
      • Medical error (unprofessionalism of the implantologist) – incorrect calculation of the place where the titanium root should be implanted, incorrect installation of the implant relative to the level of the alveolar ridge.<\/li>\n
      • Poor-quality implant system – the quality of the material from which the artificial root is made depends on the process of osseointegration. Since tissue regeneration is reduced in immunodeficiency, the quality of the implant is of paramount importance for its normal fusion with the bone.<\/li>\n
      • Non-compliance with the doctor’s recommendations regarding postoperative care, on the part of the HIV-infected patient. With poor hygiene the risk of peri-implantitis and titanium root rejection increases 5-7 times.<\/li>\n
      • Exacerbation of HIV disease – the immune system does not cope with its duties, medications are almost ineffective, postoperative wounds heal poorly, inflammation develops in the implantation area, the implant begins to reject.<\/li>\n<\/ul>\n

        \n\t The risk of infection or rejection is also present in healthy patients. But it is higher in immunodeficiency. Difficulties are possible at any stage of treatment. It is not necessary to plan implantation of implants in HIV infection with complications – because of the risk of undesirable consequences.<\/p>\n

        Methods of implantation – are they all suitable?<\/h2>\n

        \n\t When applying the classic two-stage protocol, the probability of implantation of an artificial root is low, due to the traumatic nature of the intervention. A weak immune system will not cope with the healing of the wound after the implantation procedure, repeated incision for the fixation of the crown. Therefore, the method of choice is basal implantation.<\/p>\n

        \n
        • The technology involves the installation of a titanium root through a gingival micropuncture with immediate loading with a prosthesis. The operation is performed in one stage, the implant root and abutment are a single structure.<\/li>\n
        • The use of special models of implants, implanted in deep bone layers, not subject to inflammation, atrophic processes, give high primary stability and rapid osseointegration.<\/li>\n
        • In the lateral zones, titanium roots are implanted at an angle, bypassing the sinuses, nerve plexuses, large blood vessels.<\/li>\n
        • Installation of basal implants is the best option for severe chronic pathologies, including immunodeficiency, hepatitis.<\/li>\n<\/ul>\n

          \n Minimally invasive surgery does not involve gingival incision, bone drilling and suturing. Post-operative rehabilitation is fast, with minimal discomfort for the patient.<\/strong><\/p>\n

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