Implant complications associated with systemic disorders and medications

Although dental implants have been a successful option for replacement of lost dentition for nearly five decades, their use in the medical and dental treatment plan is still in its youth. Literature on the medical implications of dental implants is surprisingly sparse, with a need for organization. This chapter is an attempt to begin the process of documenting the science behind this complex, yet critical topic. Our understanding of the mechanisms of implant success, complications, and failure unfolds from documented case histories, medical data, and clinical research. Yet, as certain as the scientific facts are, there are contradictions and cases with unexpected outcomes yielding both good and bad results. Some cases exhibit outcomes that surprisingly cross the frontier of success, while others seem to head toward failure before the clinician realizes something is wrong. The later example may begin with a common systemic disorder or medical history, seemingly straightforward from the start, only to become bewildering and strenuous to manage. For these reasons we must be critical in case selection and customize treatment plans according to medical condition while managing all medical aspects with vigor, academic excellence, and due diligence. With patient selection being the critical factor for implant success or survival, the medical condition, pharmacologic implications, and overall health of the patient cannot be overemphasized. When medical conditions are managed wisely, most patients with diseases discussed in this chapter enjoy far better overall health if they enjoy the comfort and confidence of fixed prostheses rather than the struggle, discomfort, and self-awareness of dentures in an age where esthetics and self-esteem have never been more highly valued. Now more than ever, exceptional care must be exercised to ensure that every implant is placed and restored with the objective of being as successful and as safe as possible for each patient.