Effects of different antidepressant classes on dental implant failure: A retrospective clinical study

BACKGROUND Previous studies have suggested an association between taking antidepressants and dental implant failure. This study aimed to investigate the association of different antidepressant classes with dental implant failure. METHODS This retrospective study included patients that received dental implants at the University of Florida from 2011 to 2016. The variables of implant failure, antidepressant use and classes (selective serotonin reuptake inhibitors [SSRI], serotonin-norepinephrine reuptake inhibitors [SNRI], tricyclic antidepressants [TCA], atypical antidepressants [AA], and monoamine oxidase inhibitors [MAOI]), age, gender, smoking, mild systemic diseases and implant location were obtained from patients' records. Odds ratio (OR) and confidence intervals (CI) of implant failure in patients taking different antidepressant classes, in relation to non-antidepressant users, were estimated, and the influence of multiple variables on implant failure were investigated. RESULTS 771 patients and 1820 implants were evaluated. The statistically significant predictors for implant failure included: Smoking (OR = 5.221), use of antidepressants (OR = 4.285), posterior maxilla location (OR = 2.911), mild systemic disease (OR = 2.648), and age (OR = 1.037) (P < 0.05). The frequency of implant failure was 33.3% in TCA users, 31.3% in SNRI users, 6.3% in SSRI users, 5.2% in Atypical antidepressant users, and 3.9% in non-users. Significant associations were observed between the use of SNRI (OR: 11.07; 95% CI: 3.265-33.82) and TCA (OR: 12.16; 95% CI: 1.503-71.58) and implant failure (P < 0.05). CONCLUSION Users of antidepressants were at higher risk of implant failure than non-users. Patients taking SNRI and TCA were at the highest risk of implant loss, when compared to non-users. Conclusions about TCA, however, are based on a limited number of cases. This article is protected by copyright. All rights reserved.