Masri Daya, Bar-Hai Dror, Masri-Iraqi Hiba, Kahn Adrian, Chaushu Gavriel, Chaushu Liat
Department of Oral and Maxillofacial Surgery, Rabin Medical Center, Campus Beilinson, Petah Tiqwa, Israel.
Department of Endocrinology, Rabin Medical Center, Campus Beilinson, Petah Tiqwa, Israel.
Int Dent J. 2025 Apr;75(2):1081-1087. doi: 10.1016/j.identj.2024.05.003. Epub 2024 Jul 18.
Antihypertensive medications increase osteoblasts differentiation and bone mineral formation. Osseointegration of dental implants depends on new bone formation and remodelling. Consequently, improved osseointegration may be speculated in patients receiving antihypertensive drugs. Aim - Asses the effect of antihypertensive medications on osseointegration of dental implants.
Retrospective cohort study. All individuals (792) who received at least one dental implant during a 6-year period at a single medical centre. The cohort was divided into three groups: normotensive (74.8% - 593) patients (NT group), hypertensive (23.4% - 185) patients using antihypertensive medications (HTN +med group), and hypertensive patients not using (1.8% - 14) antihypertensive medications (HTN -med group). Interventions-Installation of dental implants by experienced oral and maxillofacial surgeons with or without bone augmentation. Main measures - Early implant failure (EIF) (≤12 months from loading) reflects lack of new bone formation or excessive bone turnover during osseointegration.
The study included 792 individuals, 14 in the HTN-med group, 185 in the HTN +med group and 593 in the NT group. At the patient level, the HTN -med group were most likely (P = .041) to experience EIF 28.60% (4/14 patients). Due to the small sample of the HTN -med group, an additional analysis was carried out excluding this group. EIF of 9.70% (18/185 patients) in the HTN +med group was significantly (P = .047) lower than the NT group 14.50% (86/593 patients). 2971 implants were inserted in all study groups, 71.4% (2123) in the NT group, 26.4% (784) in the HTN +med group and 2.2% (64) in the HTN -med group. Collectively, EIF was recorded for 114 (3.84%) implants. In the HTN -med group, EIF of 6.25% (4 implants), was significantly (P < .001) higher than the two other groups. The EIF rate of the HTN +med group was 2.29% (18 implants) which was significantly less than that of the NT group 4.33% (92 implants). Controlling modifying parameters, using antihypertensive medication yielded lower EIF with marginal significance (P = .059) and OR = 0.618.
Based on statistically significant lower EIF rate found in the HTN +med group, antihypertensive medications may decrease the EIF rate of dental implants.
Clinicians should be encouraged to treat hypertensive patients with implant-supported prostheses, provided patient compliance regarding medications intake is good.
抗高血压药物可促进成骨细胞分化和骨矿物质形成。牙种植体的骨整合取决于新骨形成和重塑。因此，可以推测接受抗高血压药物治疗的患者骨整合情况会得到改善。目的——评估抗高血压药物对牙种植体骨整合的影响。
回顾性队列研究。选取在单一医疗中心6年期间接受至少一枚牙种植体的所有个体（792例）。该队列分为三组：血压正常（74.8%，593例）患者（NT组）、使用抗高血压药物的高血压（23.4%，185例）患者（HTN+med组）以及未使用（1.8%，14例）抗高血压药物的高血压患者（HTN-med组）。干预措施——由经验丰富的口腔颌面外科医生进行牙种植体植入，有或无骨增量。主要测量指标——早期种植体失败（EIF）（从加载开始≤12个月）反映骨整合过程中缺乏新骨形成或骨转换过度。
该研究纳入792例个体，HTN-med组14例，HTN+med组185例，NT组593例。在患者层面，HTN-med组最有可能（P = 0.041）出现EIF，为28.60%（4/14例患者）。由于HTN-med组样本量小，在排除该组后进行了额外分析。HTN+med组的EIF为9.70%（18/185例患者），显著（P = 0.047）低于NT组的14.50%（86/593例患者）。所有研究组共植入2971枚种植体，NT组占71.4%（2123枚），HTN+med组占26.4%（784枚），HTN-med组占2.2%（64枚）。总体而言，记录到114枚（3.84%）种植体出现EIF。在HTN-med组，EIF为6.25%（4枚种植体），显著（P < 0.001）高于其他两组。HTN+med组的EIF率为2.29%（18枚种植体），显著低于NT组的4.33%（92枚种植体）。在控制修正参数后，使用抗高血压药物使EIF降低，具有边缘显著性（P = 0.059），OR = 0.618。
基于HTN+med组中具有统计学意义的较低EIF率，抗高血压药物可能会降低牙种植体的EIF率。
应鼓励临床医生为高血压患者治疗植入支持式假体，前提是患者对药物摄入的依从性良好。
