Hypothyroidism: Implications for Implant Placement?

Dr. C. asks:
I have treatment planned a patient for multiple extractions and immediate insertion of 4-mini-implants in the mandibular symphysis area with immediate insertion of a mandibular overdenture. I will reline the overdenture with soft reline material and engage the undercuts on the mini-implants. I want my patient’s physician to insure that her hypothyroidism is stable. She has been taking synthroid for 5 years with no problems. She refuses to make an appointment with her physician because she says that synthroid is the fourth most common drug in the U. S. and so many people take the drug without complications that she does not understand why she needs a separate medical consult. Should I insist that she have this medical consult or should I just consider her stable enough for treatment?

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2 thoughts on “Hypothyroidism: Implications for Implant Placement?

  1. She at the very least would need a thyroid lab panel to ensure that her thyroid hormone levels are within normal range. I myself am euthyrotic and have had three changes, up and down, in synthroid over the last 10 years. There are generally no symptoms unless the thyroid hormone levels are wildly out of range for a relatively long (several months) period of time. However, there will be metabolic changes that could effect healing prior to overt symptoms appearing.

  2. A paper published by Zarb says that there were no differences in implant failure rate between a controlled hypothyroid group and a control group, but there was a difference in soft tissue healing and bone loss after loading.
    With mini-implants the surgical trauma is diminished, but I still would feel safer obtaining clearance from her physician before implant placement.

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