Association of different antidepressant classes with clinical attachment level and alveolar bone loss in patients with periodontitis: A retrospective study

Abstract

Objective: Our study aimed to determine the relationship of antidepressant medicine use with periodontal diseases, exploring the association of different pharmacological classes of antidepressant with observations of clinical attachment loss (CAL) and alveolar bone level (BL) in patients with periodontitis. Background: Existing evidence on the impact of antidepressant medication on periodontal tissues has focused on some classes only and is still unclear. Therefore, this retrospective study evaluated the association of different antidepressant classes with clinical attachment loss (CAL) and alveolar bone level (BL). Methods: This study was carried out in a population of patients aged ≥ 30 years old with periodontitis who sought treatment at the University of Florida from 2014 to 2018. The following variables were obtained from patients' records; usage of antidepressant medications and their pharmacological classes (selective serotonin reuptake inhibitors [SSRI], serotonin-norepinephrine reuptake inhibitors [SNRI], tricyclic, atypical, and monoamine oxidase inhibitors [MAO]), age, gender, smoking habit, mild systemic diseases, CAL, and cement-enamel junction (CEJ) and alveolar bone crest (BC) distance, defined as BL, in the Ramfjord index teeth.Results: Five hundred and eighty-two periodontitis patients were evaluated, of which 113 (19.4%) were antidepressant users. Antidepressant users exhibited significantly lower BL and fewer sites with severe CAL (≥5 mm), than non-users (p < .05). Among all single-class antidepressant users, the SSRI users showed significantly less CAL and lower BL than non-users (p < .05). Patients taking combinations of the different classes of antidepressants also showed better CAL and BL than non-users. Generalized linear models, including variables such as gender, age, systemic diseases, and smoking, demonstrated that antidepressant users were more likely to have lower mean BL and fewer sites with severe bone loss (i.e. BL > 3 and >5 mm) than non-users (p < .05).Conclusions: Antidepressant medications were associated with higher alveolar bone level and less clinical attachment loss in patients with periodontitis. When the different classes of antidepressants were analyzed individually, only the SSRI class

Association of selective serotonin reuptake inhibitor use with marginal bone level changes around osseointegrated dental implants: A retrospective study

“…15,23 Interestingly and in contrast to the present results on peri-implant MBL, antidepressants and specifically SSRIs have been associated with higher alveolar bone level and less clinical attachment loss in patients with periodontitis. 35 Although the potential mechanism of this protective effect of SSRIs on the periodontium remains unclear, their host modulatory effect of decreasing proinflammatory mediators within the periodontium stands as a plausible theory. 35 Nevertheless, there are no clinical studies testing this potential association.…”

“…35 Although the potential mechanism of this protective effect of SSRIs on the periodontium remains unclear, their host modulatory effect of decreasing proinflammatory mediators within the periodontium stands as a plausible theory. 35 Nevertheless, there are no clinical studies testing this potential association. The opposing effect of SSRIs on periodontal and peri-implant tissues could be explained by differences in the attachment (periodontium vs. osseointegration), the factors influencing bone levels (periodontitis vs. physiologic marginal bone remodeling and peri-implantitis), and the response to different stimuli (inflammatory, occlusal load) between teeth and implants.…”

Dental health of patients using antidepressants and methamphetamines

“…Оскільки пацієнти із сухістю в роті можуть вживати карієсогенні кислі напої, використовувати жувальну гумку, що містить цукор, це додатково може сприяти демінералізації поверхні зуба та карієсу. Може погіршитись утримання протезів за відсутності адекватної слинної плівки між протезами та яснами, що лежать під ними, а відсутність змащення слиною може призвести до виразки слизової оболонки, спричиненої протезом [7,12].…”