Influence of antihypertensive medications on the clinical parameters of anodized dental implants: a retrospective cohort study

Abstract

Background: Hypertension is a chronic medical condition in which blood pressure in the arteries is elevated. Given the large proportion of dental implant patients using antihypertensive medications, it is crucial to evaluate the effects of these drugs on the clinical parameters of osseointegrated implants. The aim of the present retrospective cohort study was to evaluate the influence of antihypertensive medications on clinical peri-implant tissue parameters. Methods: Thirty-five patients received a total of 77 anodized dental implants. Based on the history of the use of antihypertensive medications, the patients were divided into two groups: the group taking antihypertensive medications (AH group) and the group of healthy patients (H group). Implants were followed up clinically and radiologically, with a focus on the peri-implant soft tissue parameters probing pocket depth, bleeding on probing, modified plaque index, and marginal peri-implant bone level stability. Results: None of the implants were lost, and no technical failures occurred. The mean follow-up duration was 7 years and 1 month. A significant difference was observed in the probing pocket depth 3.8 ± 1.3 mm in the AH group and 3.0 ± 0.7 mm in the H group. In the AH and H groups, 26.5% (9/34) and 4.7% (2/43) of the patients were diagnosed with peri-implantitis at the implant level, respectively. Conclusions: Our findings suggest some correlations between antihypertensive medication use and clinical parameters in anodized peri-implant tissue.

Impact of renin-angiotensin system inhibitors and beta-blockers on dental implant stability

“…However, no subgroup analysis was performed, limiting definitive conclusions on this topic. Another recent retrospective cohort study found higher peri-implantitis rates and higher deep-pocket rates in patients prescribed with antihypertensive drugs [49]. Also here, the authors did not discriminate between the different antihypertensive drug classes, and the study further focused on other outcome measures, thus, limiting the comparability with the present study.…”

The Crucial Role of Plaque Control in Peri-Implant Mucositis Initiation as Opposed to the Role of Systemic Health Condition: A Cross-Sectional Study

“…That can be answered by Seki et al who found a negative effect of anti-hypertensive drugs on dental implants and hypothesized that bone metabolism is affected and thus deeper pockets were observed and more bone resorption. 40 That contradicted other authors who believed that drugs used for systemic diseases namely the anti-coagulants (that could be taken by some hypertensive patients) might have some protective role against peri-implant diseases, due to their secondary anti-inflammatory effects, this is what Romandini et al believed, 41 Nemati et al found out an anti-inflammatory effect for the anti-hypertensive drugs could also enhance the function of PMN’s immune cells, 42 this could contribute to a better understanding of the better scores of the patients with systemic diseases when compared to systemically healthy patients in this article.…”

Emerging factors affecting peri‐implant bone metabolism

“…Specifically, the success rate in the hypertensive group for medicated users was lower (92.5%) than that for nonmedicated users (94.1%), without a significant difference ( p = 0.939) 355 . A retrospective study reported higher bone loss, greater pocket depth, and higher prevalence of peri‐implantitis in patients under antihypertensive treatment (0.66 mm of bone loss and 30.8% of patients with peri‐implantitis) than in healthy patients (0.34 mm of bone loss and 9.1% of patients with peri‐implantitis) 356 . Calcium channel‐blocking agents may induce gingival hyperplasia with alterations in MMP metabolism and failure of collagenases activation 356 .…”

“…355 A retrospective study reported higher bone loss, greater pocket depth, and higher prevalence of peri-implantitis in patients under antihypertensive treatment (0.66 mm of bone loss and 30.8% of patients with peri-implantitis) than in healthy patients (0.34 mm of bone loss and 9.1% of patients with peri-implantitis). 356 Calcium channelblocking agents may induce gingival hyperplasia with alterations in MMP metabolism and failure of collagenases activation. 356 Finally, a recent systematic review about the topic, included only 3 studies and 959 patients.…”

“…356 Calcium channelblocking agents may induce gingival hyperplasia with alterations in MMP metabolism and failure of collagenases activation. 356 Finally, a recent systematic review about the topic, included only 3 studies and 959 patients. 357 The authors concluded that patients under antihypertensive treatment had comparable success rate and implant stability than patients not taking medications.…”