Morphometric and histologic characterization of alveolar bone from hypertensive patients

Fábris, André Luís da Silva; Mulinari‐Santos, Gabriel; Hassumi, Jaqueline Suemi; Freire, Alexandre Rodrigues; Faverani, Leonardo Pérez; Gruber, Reinhard; Okamoto, Roberta

doi:10.1111/cid.12548

Cited by 9 publications

(7 citation statements)

References 37 publications

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“…Support for this hypothesis comes from studies showing that hypertension is linked to osteoporosis, and antihypertensive drugs reduce the fracture risk, respectively (Cappuccio et al, 2000;Vestergaard et al, 2009). The clinical relevance of the present study is maybe twofold: first, losartan prevents systemic bone loss in hypertensive patients, thereby also supporting the quality of the alveolar bone before implants are placed (Bastos et al, 2010;Fabris et al, 2017). Secondly, losartan supports bone remodeling after implants were placed causing a better biomechanical stability in the long term.…”

Section: Discussionsupporting

confidence: 55%

Losartan reverses impaired osseointegration in spontaneously hypertensive rats

Mulinari‐Santos

Batista

Kirchweger

et al. 2018

Clinical Oral Implants Res

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Objective: Hypertension is not only associated with cardiovascular diseases but also with alterations in bone quality. Hypertension therefore might be a risk factor for osseointegration. Preclinical studies suggest that losartan, an angiotensin II receptor blocker widely used to treat hypertension, has a beneficial effect in graft consolidation. Here, we determine the effect of hypertension and losartan on osseointegration. Methods:We used spontaneously hypertensive rats (SHR) and normotensive Wistar albinus rats receiving losartan (30 mg/kg, p.o.) or left untreated. After 1 week, titanium miniscrews were inserted into the tibia. Sixty days after implantation, implant stability was evaluated by removal torque measurement considered the primary endpoint. Microcomputed tomography and histomorphometric analysis were secondary endpoints.Results: Losartan increased the removal torque in the hypertensive SHR group to levels of the Wistar controls. While the cortical parameters of osseointegration remained unchanged, losartan increased medullary bone formation. Microcomputed tomography revealed a higher bone volume per tissue volume and trabecular thickness in the SHR rats treated with losartan. Histomorphometric analysis further showed that losartan significantly increased the thickness of newly formed bone in medullary area in hypertensive SHR rats. Losartan did not significantly alter the parameters of osseointegration in normotensive rats. Conclusions:The data presented suggest that the angiotensin II receptor antagonist losartan increases the medullary parameters of osseointegration in a tibia model of spontaneously hypertensive rats. Considering the study limitations, understanding the impact of hypertension and the respective drugs on osseointegration requires further research. K E Y W O R D Sbone, losartan, osseointegration, renin-angiotensin system, spontaneously hypertensive rats | 1127 MULINARI-SANTOS eT AL.

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Section: Discussionsupporting

confidence: 55%

Losartan reverses impaired osseointegration in spontaneously hypertensive rats

Mulinari‐Santos

Batista

Kirchweger

et al. 2018

Clinical Oral Implants Res

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“…A retrospective cohort study included 1499 implants in 728 patients demonstrated that the patients using anti-hypertensive drugs lost only 2 implants (Table 2) [7]. Other study revealed that the histological appearance of bone derived from hypertensive patients was normal [9].…”

Section: Resultsmentioning

confidence: 99%

Hypertension and Dental Implants: A Review

Nikolopoulou¹

2019

SMOAJ

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The objectives of this study are to raise some questions in regard to the current literature, in order to study the correlation of hypertension to implant surgery. It also studies the association of hypertensive drugs with the survival or failure of dental implants. Only one study has been reported, which is associated with implant failure[0,6%] There were not many articles in this field. The findings from this recent review demonstrate that more investigation is needed concerning hypertension and failure or survival of dental implants.

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“…24 In general, antihypertensive prescriptions help in bone generation and a lesser risk of bone fractures. 25 According to a study by Seki et al, antihypertensive medicines adversely affect dental implants. Deeper peri-implant pockets and more bone resorption were seen, which may indicate a deleterious effect on bone metabolism.…”

Section: /455mentioning

confidence: 99%

Dental implant considerations in patients with systemic diseases: An updated comprehensive review

Mosaddad,

Talebi,

Keyhan

et al. 2024

J of Oral Rehabilitation

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BackgroundVarious medical conditions and the drugs used to treat them have been shown to impede or complicate dental implant surgery. It is crucial to carefully monitor the medical status and potential post‐operative complications of patients with systemic diseases, particularly elderly patients, to minimize the risk of health complications that may arise.AimThe purpose of this study was to review the existing evidence on the viability of dental implants in patients with systemic diseases and to provide practical recommendations to achieve the best possible results in the corresponding patient population.MethodsThe information for our study was compiled using data from PubMed, Scopus, Web of Science and Google Scholar databases and searched separately for each systemic disease included in our work until October 2023. An additional manual search was also performed to increase the search sensitivity. Only English‐language publications were included and assessed according to titles, abstracts and full texts.ResultsIn total, 6784 studies were found. After checking for duplicates and full‐text availability, screening for the inclusion criteria and manually searching reference lists, 570 articles remained to be considered in this study.ConclusionIn treating patients with systemic conditions, the cost–benefit analysis should consider the patient's quality of life and expected lifespan. The success of dental implants depends heavily on ensuring appropriate maintenance therapy, ideal oral hygiene standards, no smoking and avoiding other risk factors. Indications and contraindications for dental implants in cases of systemic diseases are yet to be more understood; broader and hardcore research needs to be done for a guideline foundation.

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Morphometric and histologic characterization of alveolar bone from hypertensive patients

Abstract: These observations suggest that hypertensive patients treated with renin-angiotensin system antagonists have regular alveolar bone with respect to bone structure and histological parameters.

Cited by 9 publications

References 37 publications

Losartan reverses impaired osseointegration in spontaneously hypertensive rats

Losartan reverses impaired osseointegration in spontaneously hypertensive rats

Hypertension and Dental Implants: A Review

Dental implant considerations in patients with systemic diseases: An updated comprehensive review

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