Systemic drugs that influence titanium implant osseointegration

Area of Science:

• Biomaterials Science
• Pharmacology
• Orthopedics and Dental Medicine

Background:

• Titanium implants are prevalent in orthopedic and dental fields, yet implant failures persist, causing socio-economic burdens.
• Osseointegration, the process of implant fixation, is a critical factor in implant success.
• Systemic drug delivery is an emerging strategy to modulate osseointegration.

Purpose of the Study:

• To review the effects of systemic drugs on osseointegration.
• To discuss drug classes that can enhance or impair implant fixation.
• To highlight the importance of judicious drug selection for improved patient outcomes.

Main Methods:

• Literature review of studies on systemic drug effects on osseointegration.
• Categorization of drugs into anabolic, anti-catabolic, and novel therapeutic agents.
• Analysis of drugs that may impair osseointegration, including NSAIDs and PPIs.

Main Results:

• Anabolic agents (e.g., PTH peptides, vitamin D) and anti-catabolic agents (e.g., bisphosphonates, SERMs) show positive impacts on bone mineral density and osseointegration.
• Novel therapies like DKK1 and anti-sclerostin antibodies also demonstrate beneficial effects.
• Certain post-operative drugs (e.g., NSAIDs, PPIs, SSRIs) can negatively affect osseointegration.

Conclusions:

• Systemic pharmacological agents possess the capacity to either enhance or impede titanium implant osseointegration.
• Optimizing drug selection is paramount to prevent complications and improve implant survival rates.
• Further research is needed to fully understand the impact of various medications on implant fixation.