The biggest problem with dental implants in pemphigus and pemphigoid (P/P) patients is that P/P are often treated with corticosteroids or other immune suppressants for prolonged periods of time. This makes these patient poor candidates for dental implants because the implants will usually not integrate into the bone.

Failures can also occur if the patient already has implants before they have P/P. They may also be more susceptible to periodontal disease because of their altered immune responses and altered bone metabolism.


It is at least theoretically possible that steroids could facilitate the loss of some or all of the teeth, especially if the patient has severe P/P requiring a lot of treatment. However, I doubt insurance companies would be willing to reimburse for implants because of the extremely guarded prognosis. They might consider reimbursing for conventional dentures, though.

More Detail

We consider prolonged steroid therapy as a contraindication for dental implants. There are a couple older case reports (1990, 1991) describing successful implant placement in these patients, but the papers are quite old and probably did not really confirm success.

A recent 2013 case report* described success in a patient who had only oral pemphigus vulgaris (PV) and who had steroid therapy for a relatively short time. In this report the patient had two implants placed under a full denture, and the case was followed for 32 months. The authors described very gentle but conventional implant placement and denture management but nothing out of the ordinary.

If an oral PV patient is interested in dental implants, it might be of value to have their doctor review this paper. However, I am not convinced that this small case report indicates that implant placement is highly predictable and cost effective in PV patients, and we have not elected to place implants in anyone on long-term steroid therapy regardless of the disease or disorder being treated.

*Altin, N., Ergun, S., Katz, J., Sancakli, E., Koray, M. and Tanyeri, H. (2013), Implant-Supported Oral Rehabilitation of a Patient with Pemphigus Vulgaris: A Clinical Report. Journal of Prosthodontics, 22: 581–586. doi: 10.1111/jopr.12050