Introduction & Background Today, in the general population, the long-term success of Dental implants rates is over 99% when implants are placed under ideal anatomical conditions (Arvidson et al. in Int J Oral Maxillofacialimp 7:321–329, 1992) (Fugazzotto et al. in Intern J Maxillofacial Implant 8:617–621, 1993) (Mericske-Stern and Zarb in Int J Prosthodont 6:203–208, 1993) (Spiekermann et al. in Int J Oral Maxillofac Implants 10:231–243, 1995) (Lindquist et al. in Clin Oral Implants Res, 1996). Osseointegration of dental implants happens in three phases: Stabilisation phase (phase of callous formation), Strength phase (weight bearing lamellar bone formation), and Durability phase (maintenance phase or remodelling phase). If a systemic disease affects one of these phases, the long-term success rate decreases (Roberts et al. in J Oral Implantol 12:406–416, 1986). Research indicates that 30% of dental patients present with some medical conditions, highlighting the critical need to consider systemic health in dental care (Scully in Medical Problems in Dentistry Churchill Livingstone, London, 2014). Rationale The implant surgeon hencehas a responsibility to educate oneself such that they can evaluate and manage a medically compromised patient, preventing complications and making appropriate referrals. The era when general physicians were solely responsible for assessing a patient’s fitness for surgery is long past, and surgeons can no longer rely solely on their role as surgical technicians. Methodology The medical evaluation of a patient for implants should consider the following challenges: 1. Intraoperative complication, 2. Immediate postop challenges, 3. Long-term maintenance of osseointegration. This article is designed as a narrative mini-review rather than a systematic review and integrates clinical experience with current evidence from peer-reviewed literature to address implant treatment in medically compromised patients. A targeted literature search was conducted using electronic databases including PubMed, ResearchGate, and Scopus. In addition, citation tracking of key articles relevant to the topic was utilised to identify further pertinent studies. The search focused on publications evaluating dental implant survival and success, the impact of systemic diseases on implant outcomes, and the influence of commonly prescribed medications on osseointegration and implant failure. Approach to Evidence Priority was given to systematic reviews, meta-analyses, and key clinical studies published within the last two decades to reflect contemporary implant practices. Seminal earlier studies were included where they remain clinically relevant. The selected literature was synthesised narratively to identify established findings, areas of controversy, and gaps in the existing evidence. In situations where available evidence is limited or inconclusive, clinical observations and decision-making principles derived from the author’s professional experience are included and explicitly presented as expert opinion.

Implant Treatment in Medically Compromised Patients

期刊论文
发表日期：

2026年2月16日

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G. Madhan

摘要

Introduction & Background

Today, in the general population, the long-term success of Dental implants rates is over 99% when implants are placed under ideal anatomical conditions (Arvidson et al. in Int J Oral Maxillofacialimp 7:321–329, 1992) (Fugazzotto et al. in Intern J Maxillofacial Implant 8:617–621, 1993) (Mericske-Stern and Zarb in Int J Prosthodont 6:203–208, 1993) (Spiekermann et al. in Int J Oral Maxillofac Implants 10:231–243, 1995) (Lindquist et al. in Clin Oral Implants Res, 1996). Osseointegration of dental implants happens in three phases: Stabilisation phase (phase of callous formation), Strength phase (weight bearing lamellar bone formation), and Durability phase (maintenance phase or remodelling phase). If a systemic disease affects one of these phases, the long-term success rate decreases (Roberts et al. in J Oral Implantol 12:406–416, 1986). Research indicates that 30% of dental patients present with some medical conditions, highlighting the critical need to consider systemic health in dental care (Scully in Medical Problems in Dentistry Churchill Livingstone, London, 2014).

Rationale

The implant surgeon hencehas a responsibility to educate oneself such that they can evaluate and manage a medically compromised patient, preventing complications and making appropriate referrals. The era when general physicians were solely responsible for assessing a patient’s fitness for surgery is long past, and surgeons can no longer rely solely on their role as surgical technicians.

Methodology

The medical evaluation of a patient for implants should consider the following challenges: 1. Intraoperative complication, 2. Immediate postop challenges, 3. Long-term maintenance of osseointegration. This article is designed as a narrative mini-review rather than a systematic review and integrates clinical experience with current evidence from peer-reviewed literature to address implant treatment in medically compromised patients. A targeted literature search was conducted using electronic databases including PubMed, ResearchGate, and Scopus. In addition, citation tracking of key articles relevant to the topic was utilised to identify further pertinent studies. The search focused on publications evaluating dental implant survival and success, the impact of systemic diseases on implant outcomes, and the influence of commonly prescribed medications on osseointegration and implant failure.

Approach to Evidence

Priority was given to systematic reviews, meta-analyses, and key clinical studies published within the last two decades to reflect contemporary implant practices. Seminal earlier studies were included where they remain clinically relevant. The selected literature was synthesised narratively to identify established findings, areas of controversy, and gaps in the existing evidence. In situations where available evidence is limited or inconclusive, clinical observations and decision-making principles derived from the author’s professional experience are included and explicitly presented as expert opinion.