Scully C, Hobkirk J, Dios P D
Eastman Dental Institute, University College London, London, UK.
J Oral Rehabil. 2007 Aug;34(8):590-9. doi: 10.1111/j.1365-2842.2007.01755.x.
The literature contains numerous observations on the significance of systemic disorders as contraindications to dental endosseous implant treatment, but the justification for these statements is often apparently allegorical. Although implants are increasingly used in healthy patients, their appropriateness in medically compromised patients is less equivocal. Perhaps surprisingly, the evidence of their efficacy in these groups of patients is quite sparse. Indeed, there are few if any randomized controlled trials (RCTs) in this field. Furthermore, any health risks from the placement of implants are unclear. We review the current evidence for the risks associated with endosseous implants in a range of systemic disorders. There is clearly a need for prospective systematic trials. The degree of disease-control may be far more important that the nature of the disorder itself, and individualized assessment, including the medical condition, quality of life and life expectancy is indicated. The benefits of implants to many of these patients may outweigh any risks. However, proper informed consent is mandatory.
文献中有许多关于全身性疾病作为牙内种植治疗禁忌症的重要性的观察，但这些陈述的依据往往明显是寓言性的。尽管种植体在健康患者中使用得越来越多，但在有医学问题的患者中其适用性却不那么明确。也许令人惊讶的是，关于它们在这些患者群体中疗效的证据相当稀少。事实上，该领域几乎没有随机对照试验（RCT）。此外，种植体植入带来的任何健康风险尚不清楚。我们回顾了当前关于一系列全身性疾病中与牙内种植体相关风险的证据。显然需要进行前瞻性系统试验。疾病控制程度可能远比疾病本身的性质重要，并且需要进行个体化评估，包括医疗状况、生活质量和预期寿命。种植体对许多此类患者的益处可能超过任何风险。然而，必须获得适当的知情同意。
