Proton Pump Inhibitors and the Risk of Osseointegrated Dental Implant Failure: A Cohort Study

Clin Implant Dent Relat Res. 2017 Apr;19(2):222-232. doi: 10.1111/cid.12455. Epub 2016 Oct 20.


Proton pump inhibitors (PPIs) have a negative impact on bone accrual. Because osseointegration is influenced by bone metabolism, this study investigates the association between PPIs and the risk of osseointegrated implant failure. This retrospective cohort study included a total of 1,773 osseointegrated dental implants in 799 patients (133 implants in 58 PPIs users and 1,640 in 741 non-users) who were treated at the East Coast Oral Surgery Clinic in Moncton, Canada, from January 2007 to September 2015. Kaplan-Meier estimator was used to describe the hazard function of dental implant failure by PPIs usage. Multilevel mixed effects parametric survival analyses were used to test the association between PPIs exposure and risk of implant failure adjusting for potential confounders. The failure rates were 6.8% for people using PPIs compared to 3.2% for non-users. Subjects using PPIs had a higher risk of dental implant failure (HR = 2.73; 95% CI = 1.10-6.78) compared to those who did not use the drugs. The findings suggest that treatment with PPIs may be associated with an increased risk of osseointegrated dental implant failure.

Keywords: epidemiology; medical devices; multilevel; osseointegrated implants; proton pump inhibitor.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Dental Implantation, Endosseous*
  • Dental Implants*
  • Dental Restoration Failure*
  • Female
  • Humans
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Proton Pump Inhibitors / adverse effects*
  • Proton Pump Inhibitors / pharmacology
  • Retrospective Studies
  • Young Adult


  • Dental Implants
  • Proton Pump Inhibitors