Impact of Proton Pump Inhibitors on Implant Osseointegration
Dr. Faleh Tamimi, Assistant Professor in the Faculty of Dentistry at McGill University, spoke with Dr. Chiraz Guessaier about the research he conducted and the articles he co-authored on the impact of proton pump inhibitors on implant osseointegration.
Systemic administration of omeprazole interferes with bone healing and implant osseointegration: an in vivo study on rat tibiae
- Proton pump inhibitors, over-the-counter drugs taken by millions of patients, diminish bone accrual. Accordingly, we hypothesized that these drugs could impair bone healing and implant osseointegration. This study investigated the effect of post-operative systemic administration of omeprazole on bone healing and implant osseointegration in rat tibiae.
- In 24 Sprague–Dawley rats, a titanium implant was placed in the left tibia, and a bone defect was created in the right tibia. During the 2 weeks following surgery, 12 rats were treated with omeprazole (5 mg/kg, daily) and the other 12 with saline. Then, after euthanasia, the volume (mm3) of the cortical defect and the percentages of newly formed bone in the defect, were assessed using microcomputed tomography; peri-implant bone volume/tissue volume and bone-implant contact percentage were assessed by histomorphometry.
- Omeprazole-treated rats presented larger cortical defects (2.75 ± 0.59 mm3, p = 0.003 versus 2.11 ± 0.36 mm3; p = 0.002) and a lower percentage of newly formed bone in the defects (28.62 ± 13.12; 45.89 ± 9.73; p = 0.003) than controls. Omeprazole-treated rats presented lower peri-implant bone volume/tissue volume (14.3 ± 7.3% versus 30.8 ± 11.0%; p < 0.001) and bone-implant contact (23.3 ± 10.8% versus 41.8 ± 13.3%; p < 0.001) than controls.
- Systemically administered omeprazole impairs bone healing and implant osseointegration.
Proton Pump Inhibitors and the Risk of Osseointegrated Dental Implant Failure: A Cohort Study
- Proton pump inhibitors (PPIs) have a negative impact on bone accrual. Because osseointegration is influenced by bone metabolism, this study investigates the association between PPIs and the risk of osseointegrated implant failure.
- This retrospective cohort study included a total of 1,773 osseointegrated dental implants in 799 patients (133 implants in 58 PPIs users and 1,640 in 741 non-users) who were treated at the East Coast Oral Surgery Clinic in Moncton, Canada, from January 2007 to September 2015. Kaplan-Meier estimator was used to describe the hazard function of dental implant failure by PPIs usage. Multilevel mixed effects parametric survival analyses were used to test the association between PPIs exposure and risk of implant failure adjusting for potential confounders.
- The failure rates were 6.8% for people using PPIs compared to 3.2% for non-users. Subjects using PPIs had a higher risk of dental implant failure (HR = 2.73; 95% CI = 1.10–6.78) compared to those who did not use the drugs.
- The findings suggest that treatment with PPIs may be associated with an increased risk of osseointegrated dental implant failure.
Articles Cited in the Interview
- Wu X, Al-Abedalla K, Abi-Nader S, Daniel NG, Nicolau B, Tamimi F. Proton Pump Inhibitors and the Risk of Osseointegrated Dental Implant Failure: A Cohort Study. Clin Implant Dent Relat Res. 2016 Oct 20. doi: 10.1111/cid.12455. [Epub ahead of print]
- Al Subaie A, Emami E, Tamimi I, Laurenti M, Eimar H, Abdallah MN, Tamimi F. Systemic administration of omeprazole interferes with bone healing and implant osseointegration: an in vivo study on rat tibiae. J Clin Periodontol. 2016 Feb;43(2):193-203. doi: 10.1111/jcpe.12506. Epub 2016 Feb 23.