Does the Intake of Selective Serotonin Reuptake Inhibitors Negatively Affect Dental Implant Osseointegration? A Retrospective Study

Abstract

The success of osseointegration is influenced by several factors that affect bone metabolism and by certain systemic medications. Selective serotonin reuptake inhibitors (SSRIs) have been previously suggested to be among these medications. This study aims to investigate the association between systemic intake of SSRIs and failure of osseointegration in patients rehabilitated with dental implants. A retrospective cohort study was conducted, including a total of 2055 osseointegrated dental implants in 631 patients (109 implants in 36 SSRI \users and 1946 in 595 nonusers). Predictor and outcome variables were SSRI intake and osseointegration failure, respectively. The data were analyzed with Mann-Whitney test or Fisher exact test accordingly. Both patient-level and implant-level models were implemented to evaluate the effect of SSRI exposure on the success of osseointegration of dental implants. Median duration of follow-up was 21.5 months (range = 4-56 months) for SSRI users and 23 months (range -60 months) for nonusers ( P = .158). Two of 36 SSRI users had 1 failed implant each; thus, the failure rate was 5.6%. Eleven nonusers also had 1 failed implant each; thus, the failure rate was 1.85%. The difference between the 2 groups failed to reach statistical significance at patient and implant levels ( P = .166, P = .149, respectively). The odds of implant failure were 3.123 times greater for SSRI users compared with nonusers. Patients using SSRIs were found to be 3.005 times more likely to experience early implant failure than nonusers. The results of this study suggest that SSRIs may lead to increase in the rate of osseointegration failure, although not reaching statistical significance.

Effects of different antidepressant classes on dental implant failure: A retrospective clinical study

“…Preclinical and clinical evidence suggest that antidepressant intake may compromise bone metabolism and interfere with implant osseointegration 19,25‒29,33‒35 . Our current study demonstrated that the frequency of implant failure was significantly higher in antidepressant users (13.9%) than in non‐users (3.9%) (Table 3).…”

“…Some classes of antidepressants, such as SSRI, SNRI, and TCA, were associated with bone turnover and fractures in clinical reports 21‒24 . Recently, some studies demonstrated that the administration of antidepressants might increase the risk of dental implant failure 25‒29 . However, existing literature examining the link between antidepressants and implant failure largely focuses on the SSRI class, and, surprisingly, includes users of SNRI, such as venlafaxine, as being SSRI users.…”

Clinical Decision Making for Primary Peri‐Implantitis Prevention: Practical Applications

“…Some systemic medications have been associated with a decrease in implant success through a decrease in osseointegration. Both selective serotonin reuptake inhibitors (SSRIs) and Proton Pump Inhibitors (PPIs) have been associated with increased implant failure rates 32‐35 . Both of these medications have non‐therapeutic effects on osteoblast differentiation and function and have been associated with decreased bone mineral density 36‐38 .…”

“…Both of these medications have non‐therapeutic effects on osteoblast differentiation and function and have been associated with decreased bone mineral density 36‐38 . Patients taking SSRIs were approximately three times more likely to experience implant failures compared to individuals who were not taking SSRI medications 32,33 . Similarly, individuals taking PPIs demonstrated 2 to 3 times the failure rates of those who were not taking these medications 34,35 .…”

“…Both selective serotonin reuptake inhibitors (SSRIs) and Proton Pump Inhibitors (PPIs) have been associated with increased implant failure rates. [32][33][34][35] Both of these medications have non-therapeutic effects on osteoblast differentiation and function and have been associated with decreased bone mineral density. [36][37][38] Patients taking SSRIs were approximately three times more likely to experience implant failures compared to individuals who were not taking SSRI medications.…”