Związek inhibitorów wychwytu zwrotnego serotoniny i innych leków przeciwdepresyjnych z niepowodzeniem implantów dentystycznych

Persons with mental health disorders are at increased risk of dental disease, including lost teeth. Dental implants are the preferred option for most persons who have lost teeth. Recent studies suggest that antidepressant drugs, especially the selective serotonin reuptake inhibitors, are associated with an increased risk of dental implant failure. This article provides a background about the epidemiology of loss of teeth, the causes of tooth loss, the need to replace lost teeth, and the use of dental implants to replace lost teeth. Two meta-analyses of retrospective cohort studies of the association between antidepressant use and implant failure are examined in detail. One meta-analysis included 6 studies and the other, 10 studies. An additional retrospective cohort study, published after the meta-analyses, is also examined. In summary, there is consistent evidence for a higher risk of implant failure in patients taking antidepressants, and for a higher number of implants failing in patients taking antidepressants, relative to patients not taking antidepressants. Broad findings were that, at the patient level, implant failure occurred in 6%-23% of antidepressant users vs 2%-8% of nonusers, and at the implant level, implant failure occurred in 6%-22% of antidepressant users vs 2%-9% of nonusers. Because unadjusted risks were more than doubled in antidepressant users, it implies that, in the real world, antidepressant use is a clinically important marker for risk of implant failure; it is hard to draw cause and effect inferences from the studies reviewed because of inadequacies in study designs and statistical methods. Action points are that antidepressant users should be educated about the risk of implant failure, and vigorous efforts should be made to identify and negate, to the extent possible, other risk factors for implant failure in these patients. Suggestions are offered for future research in the field.