dal sabato, 05 maggio 2018 - 08:30
al sabato, 05 maggio 2018 - 16:30
Hilton Garden INN
AIO LECCE 5 MAGGIO 2018
DENTAL IMPLANTS IN MEDICALLY COMPROMISED PATIENTS. MANAGEMENT AND KEY SUCCESS FACTORS
7 CREDITI ECM
Oral anticoagulants are a group of drugs used to treat many cardiovascular diseases. Vitamin K antagonists, which include warfarin and acenocoumarol, have a low therapeutic index as their pharmacological management is difficult and requires continuous monitoring, so the clinician must know INR values before placing dental implants. When dental implant placement is compared with simple extraction in terms of primary wound closure, implant placement allows primary flap closure, which probably results in better hemostasis and a potentially lower incidence of bleeding. Recently, the emergence of new oral anticoagulants (dabigatran, rivaroxaban, apixaban) has generated high expectations, which offer similar efficacy to traditional drugs but have fewer side effects.
Diabetes mellitus is one of the main causes of morbidity and mortality in contemporary society and has become an alarming public health problem. It is estimated diabetes will affect over 300 million by 2025. Since the 1970s, it has been understood that glycated hemoglobin A1c (HbA1c) reflects mean blood glucose levels over the previous 2?3 months and has been proposed as a diagnostic criterion for diabetes. HbA1c monitoring has therefore become an accepted means of assessing glycemia and a standard part of diabetes management. Dental implant therapies for diabetic patients can be predictable, providing these patients fall within controlled ranges of glycemia over time, assessed by monitoring HbA1c levels
Bisphosphonates and other medications are a type of drugs known to inhibit bone resorption through complex mechanisms. Medication-related osteonecrosis of the jaw (MRONJ) is an oral complication of several medication. Dental implant insertion in patients treated with this medication has been increasing. Importantly, MRONJ may appear in a peri-implant area, particularly when implants have been placed some time before starting medication. For this reason, it would appear advisable that patients who are or have been in treatment by this medication and also have dental implants should undergo a check-up every 6 month, as peri-implantitis can be a warning signal for the onset of MRONJ. Physicians must be informed and trained to deal with this "new" clinical entity, in order to establish prophylactic care, early diagnosis, and to prevent the potentially devastating consequences. Moreover, close coordination between the general practitioner prescribing this medication and the dentist is essential for reducing the risk of MRONJ.
9.00 - 11.30
Dental implants in anticoagulated patients:
Direct oral anticoagulants
Medical and dental considerations
Dental implants in patients taking antiplatelet drugs:
Dental implants and diabetes mellitus:
How can we prevent peri-implant disease in diabetic patients?
Dental implants and medication-related osteonecrosis of the jaw (MRONJ):
Where we are?
Medical considerations in implant dentistry
Full Professor of "Medically Compromised and Special Needs Patients in Dentistry" and "Drug Interactions in Dentistry". Faculty of Dentistry, University of Granada (Spain).
Co-Director of Master of Periodontology and Implant Dentistry. University of Granada (Spain).
Chairman of Pharmacological Research in Dentistry Group "CTS-654", AndalucÌa (Spain).
Awarded "Excellent" in the overall assessment of teaching quality (evaluation carried out by the University of Granada, Spain).
Post Graduate Diploma in Medically Compromised and Special Needs Patients. Faculty of Medicine and Dentistry. University of Valencia (Spain).