Implantology in patients affected by systemic diseases and on polypharmacy

OBJECTIVES The progressive increase in age in the general population, in the European Union and in particular in Italy, is necessarily leading dentists to interface with patients affected by multiple concomitant systemic diseases. These patients, who often are in polytherapy, increasingly require implant-prosthetic rehabilitation for their total or partial edentulousness. In these patients, prosthetic rehabilitation takes on an important significance, in order to guarantee a better quality of life and a re-appropriation of fundamental actions for social and psychological well-being such as eating, talking and smiling. Therefore, a careful study of the patient's medical history helps to minimize intra- and post-operative complications. The objective of this manuscript is to describe the relationship between systemic diseases, drug therapies and the decision-making process, as well as surgical rehabilitation, which every specialist must evaluate interfacing with a patient affected by systemic diseases and in drug polytherapy. MATERIALS AND METHODS This review emphasizes the importance of the patient's general health and the impact of drug therapies on implant rehabilitation. It is important to consider how some medical conditions can increase the risk of treatment failure or increase the risk of post-operative complications. Recent research of the scientific literature was carried out to guarantee, on the basis of up-to-date clinical data, useful advice to deal with the most common diseases and with their pharmacological therapies. Drug interactions in patients undergoing systemic polytherapy represent a problem which is difficult to manage even by healthcare professionals; therefore, adequate knowledge about drug therapies is a conditio sine qua non for a reliable implant rehabilitation surgery. CONCLUSIONS Polytherapy is crucial for the dentist who intends to deal with a patient with multiple systemic diseases and the continuous research, through the use of recent sources, allows to build a complete picture of the risk factors, the relative and absolute contraindications for this kind of rehabilitation, so as to reduce the risk of intra- and post-operative complications. In addition, the evaluation of the patients' medical condition ensures higher percentage of success and survival implant rate. CLINICAL SIGNIFICANCE It is imperative, in a population that has a high life expectancy and with an increasing incidence of chronic diseases, that the dentist is ready to deal with these patients with extreme accuracy. Scientific evidence is an important source that each dentist should analyze treating patients undergoing polytherapy to ensure the most predictable result. The knowledge on drug therapies and patient systemic diseases reduces the risk of errors and disputes in the community of dental practitioners; for this reason, each specialist should strive to acquire an education based on international scientific literature.