Selective Serotonin Reuptake Inhibitors and the Risk of Osseointegrated Implant Failure

Abstract

Selective serotonin reuptake inhibitors (SSRIs), the most widely used drugs for the treatment of depression, have been reported to reduce bone formation and increase the risk of bone fracture. Since osseointegration is influenced by bone metabolism, this study aimed to investigate the association between SSRIs and the risk of failures in osseointegrated implants. This retrospective cohort study was conducted on patients treated with dental implants from January 2007 to January 2013. A total of 916 dental implants in 490 patients (94 implants on 51 patients using SSRIs) were used to estimate the risk of failure associated with the use of SSRIs. Data analysis involved Cox proportional hazards, generalized estimating equation models, multilevel mixed effects parametric survival analysis, and Kaplan-Meier analysis. After 3 to 67 mo of follow-up, 38 dental implants failed and 784 succeeded in the nonusers group, while 10 failed and 84 succeeded in the SSRI-users group. The main limitation of this retrospective study was that drug compliance dose and treatment period could not be acquired from the files of the patients. The primary outcome was that compared with nonusers of SSRIs, SSRI usage was associated with an increased risk of dental implants failure (hazard ratio, 6.28; 95% confidence interval, 1.25-31.61; p = .03). The failure rates were 4.6% for SSRI nonusers and 10.6% for SSRI users. The secondary outcomes were that small implant diameters (≤4 mm; p = .02) and smoking habits (p = .01) also seemed to be associated with higher risk of implant failure. Our findings indicate that treatment with SSRIs is associated with an increased failure risk of osseointegrated implants, which might suggest a careful surgical treatment planning for SSRI users.

Survival of dental implants placed in sites of previously failed implants

“…A study (Wu et al. ) observed that treatment with selective serotonin reuptake inhibitors (SSRIs – a class of antidepressive drugs) is associated with an increased failure risk of osseointegrated implants. Some animal models (Warden et al.…”

Probing the nanoadhesion of Streptococcus sanguinis to titanium implant surfaces by atomic force microscopy

“…2,3 Ti dental implants have shown excellent survival rates in the past years, 4 however, the issue of bacterial colonization remains a problem as biofilm formation on the implant surface can lead to loss of osseointegration with subsequent treatment failure. [5][6][7] Thus, many chemical disinfection protocols have been developed to try and clean implants after surface infection, in hopes of avoiding surgical intervention and increase the survival rates of affected implants. 8 Biofilm formation comprises of a series of stages, starting with the initial adhesion of early colonizing species 9 and continued by the attachment of secondary and increasingly pathogenic bacteria that can lead to disease.…”

Smoking and dental implants: A systematic review and meta-analysis

“…99,103,104,111,112,117 clearly defined what kind of smoking patients were included in their studies based on how many cigarettes the patients used to smoke per day.Fig. 1 -Study screening process.…”