Association between Antidepressant Use and Implant Failure: A Pilot Study

Objectives: The use of both antidepressant and dental implants in the US has increased exponentially during the last decade. Antidepressants have been shown to affect bone metabolism. The purpose of this study was to estimate the strength of association between antidepressant use and implant failure.
Methods: We performed retrospective chart review. University at Buffalo HSIRB approved the study protocol. The study population consisted of patients aged 18 or older who received dental implants in the post-doctoral dental clinic between Jan 10, 2014 and Aug 27, 2014. Exposure group consisted of patients who reported using at least one type of antidepressant. Control group consisted of patients with no history of antidepressant use. Implant failure was defined as loss of at least one implant. Proportions, odds ratios (OR), and their 95% confidence intervals (CI) were obtained from cross tabulations.
Results: A total of 74 patients (41 females/33 males) received dental implants during the study period. The number of implants received per patient ranged between 1 and 11, with 44 (57.9%) patients receiving only one implant, 20 (26.3%) patients receiving two implants, 5 (6.6%) patients receiving three implants, and 3 patients receiving each (1.3%) 4, 5, and 11 implants. Six (7.9%) patients experienced implant failure, each loosing only one implant. The frequency of antidepressant use was higher in patients who experienced implant failure (33.3%) compared to those who did not (11.3%). The odds of implant failure among antidepressant drug users were about 4 times higher compared to controls (OR=3.93, 95% CI=0.61-25.51). Each year of antidepressant use was associated with 2-fold increase in the odds of implant failure (OR=2.18, 95% CI=0.68-7.02). The frequency of depression itself was not associated with implant failure.
Conclusions: Antidepressant use may be associated with dental implant failure. These results need to be confirmed by larger prospective studies.