Advances in Oral and Maxillofacial Surgery (Oct 2022)
Are selective serotonin reuptake inhibitors responsible for the failure of osseointegrated titanium-zirconium and one-piece zirconia dental implants in a premenopausal Caucasian woman? - A case report
Abstract
Introduction: Selective serotonin reuptake inhibitors (SSRIs) are a class of antidepressants used to treat depression, anxiety, panic states, and post-traumatic stress disorder (PTSD). Of particular importance is the drug treatment of SSRI, which correlates with an increased rate of dental implant loss. Literature suggests a higher risk of dental implant loss than patients not taking these medications. Presentation of the case: We report a 46-year-old Caucasian female patient who presented for the extraction of teeth 36 and 46 followed by implant placement in regions 36 and 46. With good oral hygiene, the patient started taking an SSRI one year after the implantation. Thereafter, the titanium-zirconium and zirconium implants were lost. The loss of these implants in a short period of time is particularly striking. Discussion: As the number of treatments for depression and also the number of dental implants are likely to continue to increase in the future, the combination of SSRIs and implantation will become more frequent. Given the two common treatments, the question arises whether SSRIs could be associated with dental implant loss in premenopausal Caucasian women. From an oral surgery perspective, the effects of SSRIs on bone formation are of particular concern, whilst the effects of SSRIs on the oral cavity have not been adequately studied due to the primary success of these drugs. In our case, as described in the literature, it can be assumed that the use of SSRIs after initial implantation may have a negative impact on the patient's bone remodelling. Therefore, the use of SSRIs may influence the most important factors for implant success. Conclusion: As identifying conditions that put patients at higher risk of failure enables surgeons to make informed decisions and refine the treatment plan to optimize clinical outcomes, the aim of this case report is to highlight the association between SSRI use and the risk of dental implant failure. Clinicians should therefore be aware that SSRIs must be associated with adverse effects on bone and subsequent implant loss even in generally healthy patients.
