Placement and Restoration of Dental Implants in a Patient with Paget's Disease in Remission: Literature Review and Clinical Report

Paget's disease is a disorder of bone that results in the replacement of normal bone with highly vascularized, low density bone. The diminished bone quality associated with Paget's disease is a relative contraindication to the use of dental implants, as it interferes with achievement of osseointegration. There is no current literature on the success of dental implants in patients with Paget's disease. Furthermore, there is no current literature on dental implant success in patients with remissive Paget's disease or in bone that appears to be unaffected by the disease in patients with Paget's. This case report follows the treatment of a patient with a partially edentulous maxilla and mandible (ACP PDI Classification III) who presented with remissive Paget's disease. Definitive treatment included the placement of four endosseous implants used to retain full veneer crowns. Despite the radiographic appearance of adequate bone quality, upon surgical placement it was discovered that the quality of bone was poor, yet implant survival was achieved through careful surgical management and rigid splinting of some of the endosseous implants.