Minimally invasive dental implantation in patients with chronic kidney disease

PURPOSE. To evaluate the results of dental implantation in patients with chronic kidney disease of various stages using a minimally invasive protocol (flapless) compared with traditional surgical approach.

MATERIALS AND METHODS. The prospective clinical study included 56 patients (mean age 65 ± 7.5 years) with complete maxillary or mandibular edentulism and various stages of chronic kidney disease. Patients were divided into two groups: group 1 (n = 28) – implant placement without mucoperiosteal flap reflection, group 2 (n = 28) – traditional crestal access. Oral hygiene index, early wound healing score (EHS), quality of life using OHIP-14 questionnaire, implant stability (ISQ) at surgery, at 3, 6 and 12 months, as well as glomerular filtration rate (GFR) and CKD stage were evaluated.

RESULTS. No significant differences in hygiene index were found between groups at all observation periods (p > 0.05). There were no statistically significant differences in the EHS index on days 0, 3, 7 and 10 between the groups (p > 0.05). Quality of life (OHIP-14) was significantly better in group 1 at 3 months (p < 0.001), 6 months (p < 0.001) and 4 years (p = 0.038). ISQ in the minimally invasive access group was higher at all stages. An inverse correlation was found between ISQ at 12 months and GFR (ρ = –0.38, p = 0.047), as well as a direct correlation between ISQ at surgery and EHS at day 10 (ρ = 0.40, p = 0.037).

CONCLUSION. Minimally invasive dental implantation protocol in patients with CKD stages 1–2 is associated with comparable early wound healing according to the EHS, with no statistically significant differences between groups, as well as higher quality of life and higher implant stability compared with the traditional approach. Decreased renal function may negatively affect implant stability in the long-term period.

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