Response to the Article: “Does Coronavirus Disease 2019 Infection Affect Dental Implant Integration?”

To the Editor:— I read with interest the article, “Does coronavirus disease 2019 (COVID-19) infection affect dental implant integration?” I would like to commend the author on investigating a possible link between COVID-19 infection and dental implant failure. First, I am unclear why this publication is necessary if it merely represents a communication that is "preliminary to a manuscript being submitted." Has this “communication” gone through the normal Journal of Oral and Maxillofacial Surgery peer review process? Regarding the content, to suggest at this stage that “A patient who has had recent positive testing for COVID-19 should be counseled as to possible risks that can adversely affect implant treatment, until systemic effects of COVID-19 have passed,”¹ is perhaps a premature recommendation. Does this indicate that COVID-19 infection is a relative or absolute contraindication for dental implant placement? Are specific informed consent documents required, similar to those for patients who have undergone bisphosphonate therapy? Are we not to place implants on patients with COVID-19 with long-term symptoms? How about those patients with subclinical myocarditis secondary to COVID-19? If we are making such suggestions for COVID-19, how about the other respiratory viruses that may also trigger similar inflammatory and cytokine responses? With paranoia and misinformation still present regarding many aspects of COVID-19, I do not believe we need to add an additional component of concern for patients or practitioners. All the author's concerns may be proven true, but should we not encourage the development of some multicenter randomized clinical trials to determine whether the results of a study are clinically significant? Clinical observations can serve as an excellent starting point to establish future research. It is in the best interest of the specialty to encourage the publication of well-researched and evidence-based studies to determine conclusions to best influence our clinical practice guidelines.

Thank you and be safe.