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Published on: March 14, 2025
Effect of different medications on implant complications and success rate: A retrospective study
Leonardo Mohamad Nassani1, Hanin Sager Hammoudeh2, Lisa A Lang3
1Assistant Dean for Digital Dentistry and Advanced Technology, The Ohio State University College of Dentistry, Columbus, Ohio; and Assistant Professor, Division of Restorative and Prosthetic Dentistry, The Ohio State University College of Dentistry, Columbus, Ohio.
Statement Of Problem:
Many patients undergoing dental implant therapy receive long-term medications, and antibiotics and analgesics are commonly prescribed preoperatively. The impact of these medications on implant survival and related complications, however, remains unclear.
Purpose:
The purpose of this retrospective cohort study was to identify medication-associated risk factors for complications and dental implant failures using real-world event rates of dental implant clinical performance to identify any potential correlations.
Material And Methods:
Electronic health record data from adult patients who received at least 1 single-tooth dental implant at a single academic center between 2016 and 2021 were evaluated. Demographic, medical, medication-related, implant, and outcome data were extracted and deidentified. Implant failure and mechanical and soft tissue complications were analyzed at the implant level using Kaplan-Meier and Cox proportional hazards models adjusted for clustering and prespecified covariates. Hazard ratios with 95% confidence intervals were calculated, and implants without events were censored at chart review.
Results:
Data from 1282 implants placed in 732 patients were analyzed, with an overall implant failure rate of 4.0%. Oral bisphosphonate use was associated with increased implant failure and loss of osseointegration. Antidepressant and opioid use were associated with increased mechanical and soft tissue complications, including abutment screw loosening and gingival mucositis. Self-reported antibiotic use was associated with reduced implant failure and osseointegration-related events. Perioperative antibiotics and chlorhexidine gluconate prescriptions were associated with lower rates of soft tissue complications.
Conclusions:
Self-reported and prescribed medications were associated with adverse implant outcomes. Antidepressants, opioids, and oral bisphosphonates were linked to peri-implant and mechanical complications, whereas antibiotic exposure and the use of chlorhexidine gluconate were associated with reduced soft tissue complications.
