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The association between common NSAID use and early dental implant failure: A large-scale retrospective cohort study
Georgios S Chatzopoulos1, Larry F Wolff2
1Department of Developmental and Surgical Sciences, Division of Periodontology, School of Dentistry, University of Minnesota, 515 Delaware Street SE, Minneapolis, MN 55455, USA; Department of Preventive Dentistry, Periodontology and Implant Biology, School of Dentistry, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece.
Introduction:
The impact of NSAIDs on osseointegration remains controversial, with conflicting evidence from animal models and human clinical trials. The aim of the study was to investigate the association between the use of common Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) and the risk of early dental implant failure in a large, real-world patient cohort.
Methods:
This retrospective cohort study utilized an EHR database of 12,943 patients receiving 49,997 implants. Patients were divided into an NSAID group (n = 3133) and a non-NSAID control group (n = 9810). The primary outcome was early implant failure, defined as implant removal within six months of placement. Multivariable logistic regression models were used to calculate Odds Ratios (ORs) for failure, adjusting for patient age, gender, history of diabetes, and history of osteoporosis. Analyses were conducted at both the implant and patient levels.
Results:
Patients in the NSAID group were significantly older (62.8 vs. 58.7 years, p < 0.0001) and had a higher prevalence of diabetes (22.0% vs. 16.7 %, p < 0.0001) and osteoporosis (11.0 % vs. 7.0 %, p < 0.0001). After adjusting for confounders, implant-level analysis showed that Ibuprofen use (OR 2.29; 95 % CI 1.48-3.55; p < 0.0001) and Naproxen use (OR 2.65; 95 % CI 1.22-5.75; p = 0.0137) were significantly associated with increased odds of early failure. At the patient level, the association remained highly significant for Ibuprofen (OR 2.87; 95 % CI 1.83-4.51; p < 0.0001), but not for Naproxen (p = 0.0689).
Conclusion:
The use of Ibuprofen and, to a lesser extent, Naproxen, is associated with a significantly increased risk of early dental implant failure, independent of other patient risk factors. Clinicians should consider these findings when formulating post-operative analgesic plans, particularly for patients with complex medical histories.
