Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, Riyadh, Saudi Arabia.
BMC Oral Health. 2024 Jan 5;24(1):25. doi: 10.1186/s12903-023-03772-8.
Nephrotic syndrome is a chronic disorder characterized by heavy proteinuria, hypoalbuminemia, hyperlipidemia, and edema. Idiopathic minimal-change disease is the most common form encountered in children. Corticosteroids are the cornerstone for the treatment of idiopathic nephrotic syndrome (INS), with different regimens depending on the response to therapy and frequency of relapses. This case report presents complications after implant treatment in patient with INS.
20 years old female patient presented for implant consultation. Medical history includes INS since early childhood, and she is on different medications to control her condition, including long-term steroid use. Dental history revealed that implant treatment was unsuccessful after multiple attempts. She presented with an implant on the area of lower left first mandibular molar, that shows increased mobility and radiolucency on radiographic examination. A diagnosis of implant failure was made, the implant was removed, and the area was cleaned and sutured. The patient decided to replace her missing teeth with fixed partial denture and was referred for prosthodontist. The potential adverse effect of steroid use and the possible underlying mechanism that could affect bone metabolism and implants osseointegration are reviewed.
Clinical practice guidelines are needed for the management of dental implants in chronic steroid users.
肾病综合征是一种以大量蛋白尿、低白蛋白血症、高脂血症和水肿为特征的慢性疾病。特发性微小病变性肾病是儿童中最常见的形式。皮质类固醇是治疗特发性肾病综合征（INS）的基石，根据治疗反应和复发频率有不同的方案。本病例报告介绍了 INS 患者植入物治疗后的并发症。
一名 20 岁女性患者前来咨询植入物。病史包括自幼患有 INS，她正在服用不同的药物来控制病情，包括长期使用皮质类固醇。牙科病史显示，多次尝试后植入物治疗均不成功。她的左下第一下颌磨牙区有一个植入物，显示出增加的活动度和放射透光度。影像学检查诊断为植入物失败，将植入物取出，对该区域进行了清洁和缝合。患者决定用固定局部义齿来修复缺失的牙齿，并被转诊给修复科医生。审查了皮质类固醇使用的潜在不良反应和可能影响骨代谢和植入物骨整合的潜在机制。
需要为慢性皮质类固醇使用者的牙科植入物管理制定临床实践指南。
