Each year, about 500,000 patients in North America get dental implants. Yet researchers at McGill University report that beta blockers and heartburn pills can have a significant effect on whether or not these implants are successful.
“The success of procedures like dental implants depends mainly on how the existing bone accepts the implants to create a connection between the living bone and the surface of the implant,” said Faleh Tamimi, PhD, a member of the McGill Faculty of Dentistry and a senior author on multiple papers on the subject. “Because some medications affect bone metabolism and the way that bone cells heal and multiply or die, they can have an important effect on the success of implants.”
More than 640 million patients globally take beta blockers to control hypertension. Also, more than 20 million Americans take heartburn medication, which is becoming the third most prescribed pharmaceutical product worldwide, particularly among the elderly.
The researchers reviewed data about the integration of dental implants gathered from more than 700 patients who were operated on at the East Coast Oral Surgery Clinic in Moncton, New Brunswick, Canada, between 2007 and 2015. They then confirmed the results they saw in human patients through studies in rats.
Beta blockers seem to aid implant integration. The researchers examined data for 327 implants in 142 patients who took beta blockers for hypertension and 1,172 implants in 586 people who didn’t take beta blockers. Patients on beta blockers saw a failure rate of 0.6%, while patients not on beta blockers saw a 4.1% failure rate.
“We carried out this study because we knew that beta blockers have been reported to increase bone formation. So, we thought it was possible that they would also decrease the risk of failure of dental implants. However, we didn’t expect that there would be such a clear difference in the failure rates for implants between users and non-users of beta blockers,” Tamimi said. “Randomized clinical trials will need to be carried out as well as other studies of large numbers of patients to investigate this phenomenon in depth.”
Drugs that treat heartburn, however, appear to impede integration. The data comprised 133 implants in 58 people on heartburn medication and 1,640 implants in 741 people who didn’t take heartburn medication. The failure rate was 6.8% for those on the medication and 3.2% for those not on the medication.
“Scientists already knew that drugs for heartburn reduce calcium absorption in bones and generally increase the risk of bone fractures,” said Tamimi. “That is why we wanted to look at how it affects the integration of implants and bone healing after this type of surgery. But we didn’t expect to find that the negative effects of these type of drugs would be as great as they are. Further work will need to be done to find the appropriate dosages and time periods that people should take or avoid these medications.”
The studies included:
- “Antihypertensive Medications and the Survival Rate of Osseointegrated Dental Implants: A Cohort Study” in Clinical Implant Dentistry and Related Research;
- “Propranolol Enhances Bone Healing and Implant Osseointegration; An In Vivo Study on Rats’ Tibiae” in the Journal of Clinical Periodontology;
- “Proton Pump Inhibitors and the Risk of Osseointegrated Dental Implant Failure: A Cohort Study” in Clinical Implant Dentistry and Related Research;
- “Systemic Administration of Omeprazole Interferes With Bone Healing and Implant Osseointegration” in the Journal of Clinical Periodontology