Prognostic Implication of Selective Serotonin Reuptake Inhibitors in Osseointegration of Dental Implants: A 5-year Retrospective Study.

AIM: Dental implants are the preferred treatment modality in the present edentulous era. Selective serotonin reuptake inhibitors (SSRIs) have detrimental effect on bone density. The present study was conducted to determine the effect of SSRIs on the success rate of dental implants.

MATERIALS AND METHODS: The present study was conducted on 352 patients of both genders with 680 dental implants. History of depression and SSRI medication was retrieved. Patients were divided into two groups. Group I (110 patients, 230 dental implants) patients were on SSRI, while group II (242 patients, 450 dental implants) patients were non-SSRI. In all patients, the implant failure rate was recorded.

RESULTS: In group I, 35 patients were >50 years, while 75 were <50 years of age. In group II, 60 patients were >50 years, while 182 were <50 years of age. The difference was significant (p < 0.05). Group I had 45 males and 65 females, while group II comprised of 105 males and 137 females. Group I showed 25 implant failures and group II had 21 implant failures. Age group >50 years showed 12 implant failures while <50 years had 13 in group I compared with 10 in patients >50 years and 11 in patients with <50 years of age; 56% smokers had implant in group I as compared with 60% failure in group II. In group I, 27% diabetic patients had failures as compared with 13.4% in group II. The difference was significant (p < 0.05). Group I showed maximum failures in terms of loosening of screw (8) followed by fracture of implant (7), peri-implantitis (6), and fracture of screw (4), whereas in group II, 7 cases were of loosening of screw, 6 cases were of fracture of screw, 5 cases of fracture of implant, and 3 cases of peri-implantitis. The difference was nonsignificant (p > 0.05).

CONCLUSION: Selective serotonin reuptake inhibitors cause increased osteoclastic activity, leading to bone loss and implants placed in patients with history of depression are more prone to failures.

CLINICAL SIGNIFICANCE: Failure rates of dental implants are significantly increased in patients taking SSRIs due to depression. Careful case analysis and history of depression may minimize the failure rates.