Challenges in providing comprehensive implant supported rehabilitation to a severe chronic obstructive pulmonary disease patient under general anesthesia

Title : Challenges in providing comprehensive implant supported rehabilitation to a severe chronic obstructive pulmonary disease patient under general anesthesia

Abstract:

Background: Chronic Obstructive Pulmonary Disease (COPD) patients as general and those caused by smoking in particular, pose management challenge to dental care providers. This dilemma rises even higher when implant supported rehabilitating in required. Literature review concerning osseointegration in COPD patients yielded limited information while, smoking patients demonstrate slower bone healing, diminished osseointegration and higher risk of implant failure compared to general population.

Case Summery: We present a case of 60-year-old woman who was referred to our clinic with functional and aesthetic dental impairment while, desiring implant supported fixed restoration due to gag reflex. Her underline medical condition comprised of severe COPD due to smoking history of 40 pack-years, morbid obesity and dental phobia. Prior to treatment initiation, the patient was encouraged to participate in a smoking cessation program. Following which, she underwent immediate implantation and immediate implant loading of both jaws under general anesthesia. In order to minimize the operation period duration, immediate fixed prosthesis was prefabricated using digital dental and face scanning. Subsequently, permanent fixed dental prosthesis was successfully delivered following the osteointegration period.

Conclusion: The presented case emphasizes the challenges faced by dental practitioners, when treating COPD patients with smoking history, particularly while providing implant supported rehabilitation. Furthermore, we provide the appropriate approach to managing the patent's medical and dental complexities, leading to favorable treatment outcomes.

Biography:

Dr. Eli Michaeli is the head of the Oral Medicine Department and the post graduate program at the Barzilai University Medical Center in Ashkelon. He also served as the chairman of the Israeli Society of Oral Medicine. Dr. Michaeli graduated the Faculty of Dental Medicine at Hebrew University in Jerusalem in 1999 and immediately later completed his post graduate program at the Oral Medicine Department of Hadassah Medical Center. On 2006 he concluded a two years program at the Dental Implant Center of the Faculty of Dental Medicine at Hebrew University and served as a clinical instructor since then to 2011. His main interest area includes dental care for the medically compromised patient with an emphasis on dental implantology while publishing various articles in the international literature on these topics.