Outcome of Implants in Kidney Transplant Patient Undergoing Immunosuppressive Therapy: Case Report

Yıl 2018, Sayı: 1, 47 - 51, 01.01.2018

Murat İnanç Cengiz , Seda Cengiz Nihan Atalay Nurol Arık

Öz

Since the beginning of oral implant surgery, it has been recommended to exclude certain patients with systemic health problems from implant therapy. Although many studies have been done about the effect of systemic disease like diabetes and osteoporosis on implant success but there wasn’t enough data about the effect of organ transplantation and immunosupresive therapy on implant success in the literature. As the success rate of organ transplantations increased, the number of patients on immunosupressive treatment increased. It has been reported in the literature that organ transplant patients undergoing immunosuppressive therapy may experience periodontal side-effects such as gingival overgrowth and implant failure. In our case 10 year of implant success was examined on the patient who are exposed to kidney transplantation 8 years ago and who takes cortisone and immunosupressive

Anahtar Kelimeler

Oral implant surgery, Immunosupressive treatment, Organ transplantation

İmmünosupresif Tedavi Gören Böbrek Nakli Hastasında İmplantların Sonuçları: Olgu Sunumu

Öz

Oral implant cerrahisinin başlangıcından bu yana bazı sistemik sağlık problemlerine sahip hastalarda implant tedavisi önerilmemektedir. Diyabet ve osteoporoz gibi sistemik hastalıkların implant başarısına etkisi ile ilgili pek çok çalışma yapılmasına rağmen organ transplantasyonu ve immünosüpresiflerin etkileri konusunda literatürde yeterli bilgi bulunmamaktadır. Başarılı organ transplantasyonlarının gerçekleşmesiyle immünosüpresif tedavi gören hastaların sayısı artmıştır. İmmünosüpresif tedavi alan transplantasyon hastalarında gingival büyümeler, implant başarısızlıkları gibi periodontal yan etkilerle karşılaşılabileceği bildirilmiştir. Olgumuzda 8 sene önce böbrek transplantasyonu geçirmiş, kortizon ve immünosüpresif kullanan hastada 10 yıllık implant başarısı incelenmiştir

Anahtar Kelimeler

Oral implant cerrahisi, İmmünosupresif tedavi, Organ transplantasyonu

Kaynakça

• 1. Diz P, Scully C, Sanz M.Dental implants in the medically compromised patient. journal of dentistry. 2013,41: 195 –206.
• 2. GU L, YU Y.-C. Clinical outcome of dental implants placed in liver transplant recipients after 3 years: A case series. Transplantation Proceedings, 2011, 43: 2678–2682
• 3. Duarte PM, Nogueira FGR, Sallum EA, de Toledo S, Sallum AW, Nociti FH Jr. The effect of an immunosuppressive therapy and its withdrawal on bone healing around titanium implants. A histometric study in rabbits. J Periodontol 2001; 72: 1391-1397.
• 4. Schlosberg M, Movsowtiz C, Epstein S, Ismail F, Fallon MD, Thomas S. The effect of cyclosporin A administration and its withdrawal on bone mineral metabolism in the rat. Endocrinol 1989;124:2179-2184
• 5. Orcel P, Dene MA, De Vernejoul MC. Cyclosporin-A in vitro decreases bone reseption, osteoclast formation, and the fusion of cells of the monocyte-macrophage lineage. Endocrinol 1991;128:1638-1646.
• 6. Kawana K, Takahashi M, Kushida K, Hoshino H, Sakata S, Inoue T. The effect of cyclosporin A administration on bone metabolism in the rat evaluated by biochemical markers. J Endocrinol Invest 1996;19:499-504.
• 7. del Pozo E, Lippuner K, Ruch W, et al. Different effects of cyclosporin A on bone remodelling in young and adult rats. Bone 1995;16:271S-275S.
• 8. Fu E, Yao-Dung H, Nieh S, Wikesjö UME, Liu D. Effects of cyclosporin A on alveolar bone: An experimental study in the rat. J Periodontol 1999;70:189-194.
• 9. Duarte P, Filho G, Sallum E, et al. The effect of an immunosuppressive therapy and its withdrawal on bone healing around titanium implants. A histometric study in rabbits. J Periodontol. 2001;72:1391–1397.
• 10. Scully C, Hobkirk J, Dios PD. Dental endosseous implants in the medically compromised patient. J Oral Rehabil 2007,34:590-599.
• 11. Torre D, Burtscher D. Ridge augmentation in an organ transplant patient. International Journal of Oral and Maxillofacial Surgery.2016,45 (5):658–661
• 12. Radzewski R, Osmolak K. The use of dental implants in organ transplant patients undergoing immunosuppressive therapy: An overview of publications. Implant Dentistry. 2016,25(4):541-546.
• 13. Szubińska-Lelonkiewicz D, Golecka-Bąkowska M, Osiak M. The algorithm of dental treatment in patients before and after organ transplantation. Dent Med Probl.2017;54(2):183–187.
• 14. Oliveira G, et al. Effect of systemic administration of cyclosporine on the repair of critical size calvaria defects in rats. Clinical Oral Implants Research. 2014, 25(10): 289.
• 15. Cipriani RE, Farias ML. Osteoporose após transplante de órgãos sólidos. Arq Bras Endocrinol Metabol. 2005;49(3):369-77.
• 16. Boling EP. Secondary osteoporosis: underlying disease and the risk for glucocorticoid-induced osteoporosis. Clin Ther. 2004;26(1):1-14
• 17. Heckmann S, Heckmann J, Linke J, et al. Implant therapy following liver transplantation: Clinical and microbiological results after 10 years. Periodontol. 2004; 75:909–913.
• 18. Gu L, Yu Y. Liver: Clinical outcome of dental implants placed in liver transplant recipients after 3 years: A case series. Transplant Proc. 2011;43:432678–432682.
• 19. Gu L, Wang Q, Yu Y. Eleven dental implants placed in a liver transplantation patient: A case report and 5-year clinical evaluation. Chin Med J (Engl). 2011;124: 472–475.
• 20. Montebugnoli L, Venturi M, Cervellati F. Bone response to submerged implants in organ transplant patients: A prospective controlled study. Int J Oral Maxillofac Implants. 2012;27: 1494–1500.
• 21. McCauley LK, Rosol TJ, Charles CC. Effects of cyclosporine A on rat osteoblasts (ROS17/2.8 cells) in vitro. Calcif Tissue Int 1992;521:291-297.
• 22. Buchinsky FJ, Ma Y, Mann GN, et al. T lymphocytes play a critical role in the development of cyclosporin A-induced osteopenia. Endocrinol 1996;137:2278-2285
• 23. Cota LO, Aquino DR, Cortelli JR, Cortelli SC, Costa FO. Gingival overgrowth in subjects under immunosuppressive regiments based on cyclosporine, tacrolimus or sirolimus. J Clin Periodontol. 2010;37:894–902.
• 24. Radwan-Oczko M, Boratyńska M, Klinger M, Ziętek M. Risk factors of gingival overgrowth in kidney transplant recipients treated with cyclosporine A. Ann Transplant. 2003;8,57–62.