Dental implants in a young patient on Remicade infusions for cervical spondylitis?

Last Updated: Apr 05, 2017

I have a 39 year old male, non-smoker, with cervical spondylosis who gets an infusion of infliximab (Remicaide) every 6 weeks. He is not taking methotrexate or a steroid. I have recently extracted #30 and #19. Both had failed root canal treatment and vertical fractures. I am planning on inserting an implant in each site. Does anyone have any recommendations on how to proceed? Should we stop infliximab (remicaide) 1 month prior to implant insertion or does it not matter? Will this have a significant influence on osseointegration?

4 Comments on Dental implants in a young patient on Remicade infusions for cervical spondylitis?

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Doc

04/11/2017

The recommendation is to forget implants. Remicaid is not a friend of bone healing. They will fail--and this bone is already quite sick. Implant success absent Remicaid would still be quite iffy here!. Even then the sites Would need at least a year to heal.

Vipul G Shukla

04/18/2017

Thanks Doc for your encouraging comments. Besides immunosuppression, Remicade has little other effect on humans. But I will tread with caution. Any other input from anyone else? -Dr. VS

greg steiner

04/26/2017

Remicade will have little effect on integration and may actually improve bone metabolism. If the extraction site heals within normal limits I would have no problem placing an implant in this patient. Here is a study that supports improved bone metabolism with Remicade therapy. Eur J Gastroenterol Hepatol. 2016 Nov;28(11):1335-44. doi: 10.1097/MEG.0000000000000719. A 1-year prospective study of the effect of infliximab on bone metabolism in inflammatory bowel disease patients. Greg Steiner Steiner Biotechnology

Vipul G Shukla

04/27/2017

Appreciate your advice, Dr. Steiner. I will watch how his bone healing progresses, and make the call based on that parameter. Thank you. Dr. VS

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