Selective Serotonin Reuptake Inhibitors May Increase Implant Failure

Abstract

Background: 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.

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

Study design: 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.

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

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

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

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

Results: 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).

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