Selective Serotonin Reuptake Inhibitors May Increase Implant Failure

Patients receiving dental implants may take selective serotonin reuptake inhibitors (SSRI). There may be an association with taking an SSRI at implant placement and implant failure.

The study's purpose was to estimate the association between SSIR exposure and implant failure.

The study design was a retrospective cohort study. The sample was patients who received dental implants between December 1, 2007, and February 29, 2020. Patients were excluded if the follow-up was <12 months.

The predictor variable was SSRI exposure at the time of implant placement coded as exposed or not exposed.

The primary outcome variable was implant status at 1 year, coded as survived or failed.

The covariates were age, sex, and implant location and per subject, and comorbidities included smoking, diabetes, osteoporosis, and frailty.

Bivariate statistics assessed the association between SSRI exposure at the time of implant placement and failure with significance at P value < .05.

The sample was composed of 1,611 subjects (mean age 57.3 ± 15.8 years, 893 (55.4%) females) with 3,184 implants placed. There were 1,514 (94%) subjects who did not take an SSRI at implant placement (mean age 57.5 ± 15.5 years, 813 (53.7%) females) and there were 97 (6%) subjects who did take an SSRI at implant placement (mean age 61.6 ± 13.1 years, 80 (82.5%) females). The failure rate was 6.7% (101 subjects) for non-SSRI exposed subjects and 18.6% (18 subjects) who took an SSRI at implant placement. SSRI exposure was associated with implant failure at 1-year relative risk = 2.8; 1.8-4.4 (relative risk, 95% confidence interval). Covariates with association with failure: smoking odds ratio (OR) = 0.98, 1.5-5.5 (OR, 95% confidence limits, P < .0001), diabetes (OR = 1.8, 95% confidence interval [CI], P = .048), alcohol (OR = 1.9, 95% CI, P = .045), osteoporosis (OR = 14.1, 95% CI, P < .0001), debilitation (OR = 20.7, 95% CI, P < .0001), and bisphosphonates (OR = 0.09, 95% CI, P = .004).

Patients who take SSRI at the time of implant surgery may have an increased risk for implant failure.