Preoperative evaluation and surgical planning for dental implant in a patient with systemic comorbidities: a case report

Oral rehabilitation with dental implants in patients with systemic comorbidities presents a challenge that demands heightened attention and meticulous surgical planning. Conditions such as systemic arterial hypertension, type 2 diabetes mellitus, and periodontal disease can directly interfere with healing, increase the risk of infection, and compromise the long-term success of implants. Therefore, a thorough clinical evaluation, prior control of these conditions, and an interdisciplinary approach are essential to ensure a favorable prognosis. Hypertensive patients, for instance, may exhibit vascular alterations that heighten the risk of bleeding during and after the procedure, necessitating strict blood pressure control in collaboration with the attending physician. In diabetic patients, chronic hyperglycemia impairs the inflammatory response and healing process, making glycemic monitoring, prophylactic antibiotic therapy, and rigorous aseptic measures imperative. In cases of periodontal disease, the presence of active gingival infections may predispose the patient to peri-implantitis, underscoring the importance of eliminating infectious foci prior to surgery. Thus, the success of implant-based rehabilitation in patients with these conditions depends not only on the surgical technique but also on comprehensive planning. This includes laboratory and imaging examinations, careful selection of materials, and diligent postoperative follow-up.