Effects of Drugs and Chemotherapeutic Agents on Dental Implant Osseointegration: A Narrative Review

Abstract

Background: Dental implants have been one of the most popular treatments for rehabilitating individuals with single missing teeth or fully edentulous jaws since their introduction. As more implant patients are well-aged and take several medications due to various systemic conditions, clinicians should be mindful of possible drug implications on bone remodeling and osseointegration. Objective: The present study aims to study and review some desirable and some unwelcomed implications of medicine on osseointegration. Methods: A broad search for proper relevant studies were conducted in four databases, including Web of Science, Pubmed, Scopus, and Google Scholar. Results: Some commonly prescribed medicines such as nonsteroidal anti-inflammatory drugs (NSAIDs), glucocorticoids, proton pump inhibitors (PPIs), selective serotonin reuptake inhibitors (SSRIs), anticoagulants, metformin, and chemotherapeutic agents may jeopardize osseointegration. On the contrary, some therapeutic agents such as anabolic, anti-catabolic, or dual anabolic and anti-catabolic agents may enhance osseointegration and increase the treatment’s success rate. Conclusion: Systemic medications that enhance osseointegration include mineralization promoters and bone resorption inhibitors. On the other hand, medications often given to the elderly with systemic problems might interfere with osseointegration, leading to implant failure. However, to validate the provided research, more human studies with a higher level of evidence are required.

Prevention and management of drug‐induced osteonecrosis of the jaws using platelet‐rich fibrin: A clinical feasibility study

“…In addition, PRF was used by others to prevent MRONJ due to the high concentration of platelet‐derived growth factors (PDGF), which plays a crucial role as an essential regulator for the migration, proliferation, and survival of mesenchymal cells. In addition, PRF contains transforming growth factor‐β1, a growth factor that is released by autologous bone, which stimulates synthesis of type 1 collagen and fibronectin and vascular endothelial growth factor (VEGF), the most potent growth factor leading to tissue angiogenesis (Mohammadi et al, 2022 ).…”

“…In recent years, some therapeutic protocols have been proposed to enhance the healing and the predictability of the surgical treatment, such as ozone therapy (Ripamonti et al, 2011 ), low‐level laser therapy (Sarkarat et al, 2019 ; Scoletta et al, 2010 ), hyperbaric oxygen (Freiberger et al, 2012 ), autologous platelet concentrates (APCs) (Adornato et al, 2007 ; Del Fabbro et al, 2018 ; Miranda et al, 2021 ; Sarkarat et al, 2014 ) and combination therapies (Sarkarat et al, 2022 ). The combination of the surgical treatment and autologous membranes of platelet‐rich fibrin (PRF) has the objective of adding bioactive factors to the surgical site to accelerate bone and soft tissue healing (Adornato et al, 2007 ; Mohammadi et al, 2022 ; Nørholt & Hartlev, 2016 ; Sabri et al, 2022 ). Recent systematic reviews on this topic have concluded that there is still insufficient evidence to prove the true benefits of platelet concentrates in the healing of ONJ lesions (Fabbro et al 2015 , 2018 ; Fortunato et al, 2020 ; Lopez‐Jornet et al, 2016 ).…”

The Effect of Anticoagulants on Early Implant Failure: A Retrospective Cohort Study

“…A recent review revealed that non-steroidal anti-inflammatory drugs, glucocorticoids, proton pump inhibitors, selective serotonin reuptake inhibitors, anticoagulants, metformin, and chemotherapeutic agents may jeopardize osseointegration and lead to implant failure. However, validation is mandatory from human studies with high evidence [24].…”