Tratamiento odontológico del paciente infectado por el virus de la inmunodeficiencia humana

Abstract

The demand for dental care of patients with human immunodeficiency virus (HIV) infection is increasing. In turn, dentists ' disposition to treat such patients has also increased - probably because studies ha ve shown the risk of occupational transmission through dental practice to be mínima!. Extractions are the most common procedures in HJV-infected patients, and the prophylactic administration of antibiotics is not advised, except in the presence of neutropenia or severe immune depression. The incidence of post-extraction complications is similar to that observed in the general population, though complications nevertheless increase with the difficulty of extraction and the severity of immune suppression. The periodontal lesions described in subjects with HIV infection probably reflect different expressions of the same process, and their management is very similar, with combinecl local mechanical measures, the administration of antimicrobials and the implementation of oral hygiene protocols. Conventional endodontics requires no special precautions, and the incidence of complications is similar to that observed in non-infected patients. Molar endodontics is not recommended, however. The treatment of periapical lesions should be early and aggressive in patients with HIV infection, in arder to avoid exacerbations in advanced stages of the disease.