口腔自身免疫性疾病患者的牙种植

T. Tounta
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引用次数: 2

摘要

口腔表现,以及这些患者的药物治疗,会影响口腔上皮和骨质量,这是种植体骨整合和长期成功的重要因素4。口腔黏膜自身免疫性疾病包括多种疾病,如口腔扁平苔藓(OLP)、寻常型天疱疮(PV)、粘膜(MMP)和大疱性类天疱疮(BP)、获得性大疱性表皮松解症(EBA)、系统性红斑狼疮(SLE)和Sjögren综合征(SS),并可引起口腔上皮的疼痛性糜烂、水疱和溃疡。这些疾病使牙齿卫生复杂化,并可能导致牙齿脱落。当天然牙齿缺失时,种植牙可以提高这些患者的生活质量。骨整合是牙种植体成功的必要条件,对于口腔黏膜自身免疫性疾病患者并不禁用。然而,临床牙医必须考虑口腔自身免疫性疾病对口腔上皮的可能影响,这可能会影响种植的成功,也因为日常口腔卫生的困难,导致种植体周围的骨吸收。此外,被批准用于治疗此类疾病的药物,如皮质类固醇、免疫抑制剂和非甾体抗炎药(NSAIDs),可能会刺激骨整合,因为它会损害骨质量,影响患者的整体健康。然而,这些药物对种植手术的影响取决于药物的剂量和持续时间,通常牙种植是可能的。
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Dental implants in patients with oral autoimmune diseases
with oral manifestations, as well as the medication intended for these patients, can affect the oral epithelium, as well as the bone quality, which are both important factors of implant osseointegration and long term success 4 . Abstract Oral mucosal autoimmune diseases include a variety of disorders, like oral lichen planus (OLP), pemphigus vulgaris (PV), mucous membrane (MMP) and bullous pemphigoid (BP), epidermolysis bullosa acquisita (EBA), systemic lupus erythematosus (SLE) and Sjögren syndrome (SS) and can cause painful erosions, blisters and ulceration at the oral epithelium. Such diseases complicate dental hygiene and can lead to tooth loss. When natural teeth are missing, dental implants can improve quality of life for these patients. Osseointegration is necessary for dental implant success and is not contraindicated for patients with oral mucosal autoimmune diseases. However, the clinical dentist must consider the possible impact of oral autoimmune diseases on the oral epithelium that might affect implant success, also due to the difficulty of everyday oral hygiene, leading to bone absorption around the implant. Moreover, medication approved for the therapy of such diseases, such as corticosteroids, immunosuppressants and non-steroidal anti-inflammatory drugs (NSAIDs) could provoke osseointegration, as it compromises bone quality and affects the patient’s general health. However, the impact of these drugs on implant surgery depends on dose and duration of the drug and usually dental implantation is possible.
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