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Lupus: Precautions? Contraindication for Implants?

posted in Dental Implant Contraindications, advice

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Anon asks:
I have a 55 year old female patient with Systemic Lupus Erythematosus. I would like to treatment plan her for dental implants. Are there any lab tests I should order? What should I ask her physician to comment on? Any absolute contraindications for implants? Any special precautions? I have been having difficulty getting information on this. What are your recommendations for implant treatment of this patient?

3 Responses to “ Lupus: Precautions? Contraindication for Implants? ”

• Dr. Mehdi Jafari December 28th, 2007

  
  

  Lupus is a chronic inflammatory auto-immune disease. Inflammation caused by lupus can affect many different body systems, including joints, skin, kidneys, blood cells, heart and lungs.Four types of lupus exist(systemic,discoid,drug-induced,neonatal), of these, systemic lupus erythematosus is the most common and serious form of lupus.Patients with lupus are vulnerable to infection because both the disease and its treatments, corticosteroid and cytotoxic drugs affect the immune system, although, infection can bring on a lupus flare, increasing the risk of infection even more.Lupus increases the risk of cancers like non-Hodgkin’s lymphoma, lung cancer; and liver or bile duct cancers.Avascular necrosis of bones may occure and lead to multiple pathologic fractures. Three types of drugs are commonly used to treat lupus; nonsteroidal anti-inflammatory drugs, corticosteroids and immunosuppressives.Recently, stem cell transplant and Rituximab (a B-lymphocyte decreasing agent) has been used to control the disease.When thinking about placing implants in a patient suffering from the disease, the above mentioned data should always be considered.Merry Christmass, happy new year and my best wishes for everybody.

• Dr.Kimsey January 8th, 2008

  
  

  An additional comment is that very often these patients end up on bisphosphonates to treat the osteoporosis that the steroids cause. Typically you might of a window of time when the lupus has calmed down enough that the dosages of the immunosupressant drugs are lower and the patient is not yet on the bisphosphonates. Absolutely consult with m.d. and lay out the risks.

• Dawn May 21st, 2009

  
  

  I am 63 years old and require multiple titanium implants. My local dentist won’t even send for an implant consultation because he states that the lupus prohibits this. I have rarely taken steroids (my doctor said it would destroy my kidneys) I have had heart and lung problems but no problems with my bones. I have a series of dental problems because of at 12 years old I fell off a pogo-stick. My bone density tests all come back negative for any bone loss. Isn’t the question of continuing infections from torqued or ill fitting bridges more serious than other possible infection from implants?

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