In order to improve the chances of dental implants attaching properly, research suggests taking beta blockers, at least temporarily, and stopping heartburn medication.
Each year, about 500,000 North Americans get dental implants. More than 640 million patients around the world take beta blockers to control hypertension, and more than 20 million Americans, about one in 14 people, take heartburn medication.
“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,” says professor Faleh Tamimi, who teaches in the McGill Faculty of Dentistry, and is the senior author of a number of papers published on the subject in recent weeks.
“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.”
The research team reviewed data about the integration of dental implants gathered from over 700 patients who were operated on at the East Coast Oral Surgery Clinic in Moncton, New Brunswick, between 2007 and 2015. They then confirmed the results they saw in human patients through studies in rats.
“We believe that this research may have implications for orthopedic interventions such as hip and knee replacements, because the same mechanisms of bone cell growth break down, and healing take place in all the bones in the body,” says Tamimi. “Our work with implants in rats suggest that this is indeed the case, but further research will be needed to confirm it.”
Conclusions of the beta-blockers study are based on 1,499 dental implants in 728 patients. 327 implants were in 142 people who took beta blockers for hypertension and 1,172 implants were in 586 people who didn’t take beta blockers. The failure rates of implants for people using beta blockers was 0.6 percent, whereas the failure rate of implants in people who don’t take beta blockers was 4.1 percent.
“We carried out this study because we knew that beta blockers have been reported to increase bone formation,” says Tamimi. “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. Randomized clinical trials will need to be carried out as well as other studies of large numbers of patients to investigate this phenomenon in more depth.”
A second study suggests that heartburn drugs can impede the integration of dental implants. The findings come from a study with 1,773 dental implants in 799 patients—133 implants were in 58 people who took heartburn medication, and 1,640 implants were in 741 people who don’t take heartburn medication.
Failure rates of implants for people using heartburn medication were 6.8 percent. By contrast, failure rates of implants for people not taking heartburn medication were 3.2 percent.
Heartburn medication is rapidly becoming the third most prescribed pharmaceutical product worldwide, especially for elderly people, who take it either on an occasional or long-term basis.
“Scientists already knew that drugs for heartburn reduce calcium absorption in bones and generally increase the risk of bone fractures,” says 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.”
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The human beta blockers study appears in Clinical Implant Dentistry and Related Research. Funding for that work came from the China Scholarship Council, Clifford Wong Fellowships, James P. Lund Fellowship in Dentistry, Canadian Institutes of Health Research, Institutes of Musculoskeletal Health and Arthritis, and the Le Réseau de recherche en santé buccodentaire et osseuse, Canada Research Chair program.
The related study in rats appears in the Journal of Clinical Periodontology. The Canadian Institute of Health Research, the Saudi Arabian Cultural Bureau in Canada, Natural Sciences and Engineering Research Council of Canada, the Canadian Foundation for Innovation, AO Foundation, and International Team for Implantology funded that work.
The heartburn medication study in humans appears in Clinical Implant Dentistry and Related Research. Funding came from the China Scholarship Council, Clifford Wong Fellowships, James P. Lund Fellowship in Dentistry, Canadian Institutes of Health Research, Institutes of Musculoskeletal Health and Arthritis, and the Le Réseau de recherche en santé buccodentaire et osseuse, Canada Research Chair program.
The related work with rats appears in the Journal of Clinical Periodontology and was funded by the Canadian Institute of Health Research, the Saudi Arabian Cultural Bureau in Canada, Natural Sciences and Engineering Research Council of Canada, the Canadian Foundation for Innovation, AO Foundation, and International Team for Implantology.