Dr. B., asks:
I have a patient who was diagnosed with Paget’s Disease. According to her physician, her alkaline phosphatase levels have stabilized. Is there any contraindication to dental implant placement in this type of case? What special precautions are indicated? I would like to treatment plan this patient for dental implants but am reluctant to proceed until I know more about the interaction between Paget’s Disease and dental implants.
OsseoNews.com Editor’s Note: Paget’s disease, also called osteitis (pronounced ah-stee-eye-tis), causes a malfunction in the normal process of bone remodelling. Normally, bone is continually breaking down and rebuilding. This usually slow process of bone destruction and growth is somehow altered in Paget’s disease.
Though I have no experience treating patients with Paget’s disease, I have two simple suggestions:
First, interprete the bone scan, if there is one; ask for one, if there isn’t. Determining wheter maxillary bones are affected or not should be the first step on a reasonable treatment plan for such a patient.
Second, find out about the current medical treatment and associated medicines. Bisphosphonates can be a part of the patient’s therapy, and the risk of developing BON should be considered and informed to the patient.
I was diagnosed with the begin form of osteopetrosis by a random x-ray in my 40′s and have had no symptoms at this point in my 50′s. When I mention this diagnosis, most of the time my dentist and periodontist act like they don’t know what I’m talking about. I am concerned and I don’t think I’m a good candidate for dental implants instead of a bridge as they keep recommending. Is there a type of dentist that specializes in this area?