Multiple Sclerosis : Contraindication for Implants?

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Dr. B. asks:

I have a 54 year old female patient interested in multiple dental implants for fixed restorations. She has been diagnosed with multiple sclerosis last year and tells me she functions well enough, holds a job, looks after her family, etc.

I could not find literature supporting or refuting implants in her condition. Hypercholesteremia (treated with statins) is the only other significant medical history in her case. Any suggestions or experiences?

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4 Responses to “ Multiple Sclerosis : Contraindication for Implants? ”

• Dr. Mehdi Jafari August 14th, 2007

  
  

  Multiple Sclerosis (MS) is an inflammatory relapsing or progressive disorder of CNS white matter and is a major cause of disability in young adults. Pathologically, it is characterized by multifocal areas of demyelination, loss of oligodendrocytes, and astrogliosis but with relative preservation of axons. In MS, the body mistakenly directs antibodies and white blood cells against proteins in the myelin sheath, a fatty substance that insulates nerve fibers in the brain and spinal cord. This results in inflammation and injury to the sheath and ultimately to the nerves that it surrounds. The result may be multiple areas of scarring (sclerosis).This damage can slow or block the nerve signals that control muscle coordination, strength, sensation and vision. MS is unpredictable and varies in severity. In some people, multiple sclerosis is a mild illness, but it can lead to permanent disability in others. Treatments can modify the course of the disease and relieve symptoms. There is as yet no definitive cure for MS. Many patients do well with no therapy at all, especially since many medications have serious side effects and some carry significant risks. Beta interferon has been shown to reduce the number of exacerbations and may slow the progression of physical disability. When attacks do occur, they tend to be shorter and less severe. The FDA has approved a synthetic form of myelin basic protein, called copolymer I, for the treatment of relapsing-remitting MS, and an immunosuppressant treatment, Novantrone, for the treatment of advanced or chronic MS. The other drugs of use are; Glatiramer which is an alternative to beta interferons, Natalizumab which works by blocking the attachment of immune cells to brain blood vessels and Corticosteroids to reduce inflammation in nerve tissue and to shorten the duration of flare-ups. Those patients, who receive steroids for treatment, may bear the side effects of these kinds of drugs as well. The vast majority of patients are mildly affected, but in the worst cases, MS can render a person unable to write, speak or walk. Improving the lives of people with MS rests on better understanding of their needs and their successes and by looking into the conditions of life with MS. Maintaining the needs of MS patients, is also an essential element of measuring the effectiveness of any sort of therapeutic intervention—be it a rehabilitation process, a self-help program, or a disease-modifying therapy. A better quality of life can be offered to the patients by providing them with functional mastication and a better nutrition and might help the patients to cope with the underlying disease.

• MD Zim August 14th, 2007

  
  

  Multiple sclerosis is not a contraindication for placement of dental implants; however caution is to be exercised when planning the treatment, especially in advanced cases and cases which have had prolonged treatment with steroids.

• David A. Foreman D.M.D. August 15th, 2007

  
  

  I have one patient with MS that has 2 implants in #18,19 positions for more than 8 years. The implants are well integrated, and have stayed that way for their 8 plus years in functon. Not a scientific paper, but a successful clinical case

• Dr.Kimsey August 15th, 2007

  
  

  No contraindications other than that mentioned above but some of the Neurologists that treat M.S. patients and some patients have unfounded fears and concerns about use of dental implants or even root canals in m.s. patients.

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Sun July 20 2008

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