Dental implants in a young patient on Remicade infusions for cervical spondylitis?
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
4/11/2017
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
4/18/2017
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
4/26/2017
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
4/27/2017
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
