Influence of antihypertensive medications on the clinical parameters of anodized dental implants: a retrospective cohort study

Background

Dental implants are the best option for replacing missing teeth, which show sufficient longevity in most cases. Even though dental implants have a long-term success rate of more than 90%, some people experience complications as with any treatment modality. Technical and biological complications can occur in implant dentistry [1]. The biological complications related to dental implants include peri-implant mucositis and peri-implantitis. There is no definitive evidence regarding the etiology and clinical countermeasures for these two biological complications [2]. Various risk indicators have been discussed, and etiological similarities between periodontal and peri-implant tissues have been of interest to clinicians and researchers [3]. Both periodontitis and peri-implantitis are initiated by the accumulation of microbial biofilms on the hard surfaces of the teeth or dental implants [4, 5].

Researchers have recently shown considerable interest in possible links between periodontal disease and systemic diseases and conditions, such as diabetes mellitus, cardiovascular disease, bacterial pneumonia, and low birth weight [6]. Systemic diseases may impair the host’s barrier function and immune defense against periodontal pathogens, creating an opportunity for destructive periodontal disease and likely peri-implant diseases. Systemic diseases and medications may also interfere with healing in peri-implant sites and increase the risk of biological complications and implant failure [7].

In 2017, new guidelines from the American Heart Association, the American College of Cardiology, and nine other health organizations lowered the blood pressure criteria for the diagnosis of hypertension to 130/80 mmHg and higher for all adults [8]. The previous guidelines set the threshold at 140/90 mmHg for individuals younger than 65 years and 150/80 mmHg for those aged 65 years and older. It could then be estimated that 70 to 79% of men aged 55 years and older are classified as having hypertension.

The prevalence of hypertension is increasing in individuals older than 60 years in developed countries. Patients with hypertension also require dental implant therapy. Thus, the influence of antihypertensive medications on peri-implant tissue has been of great interest. Wu et al. conducted a retrospective cohort study on 728 patients that assessed the influence of antihypertensive medications on implant survival rates [9]. The study demonstrated a higher survival rate of osseointegration implants in patients prescribed with antihypertensive medications (hazard ratio, 0.12; 95% confidence interval [CI], 0.03–0.49). The authors explained this effect by the relationship between antihypertensive medication use and bone metabolism. This is the only study that has assessed the relationship between antihypertensive medication use and implant-related outcomes.

Peri-implant diseases should ideally be diagnosed in the early stages to prevent complications and achieve longevity. Although the implant survival rate would be the true endpoint for dental implant treatment, clinical surrogate endpoints are useful for detecting early onset of peri-implant disease [10]. For this purpose, it is necessary to further investigate the influence of antihypertensive medications on peri-implant clinical endpoints.

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Biological peri-implant complications have a multifactorial etiology. Besides patient systemic factors, several other etiological factors for peri-implant complications also exist. It is well known that a myriad of possible risk factors could be associated with dental implant characteristics. Thus, to assess the impact of medications, patients who received implants with the same characteristics should be included in both the test and control groups. A recent systematic review showed lower failure rates for anodized implants than for turned implants as well as titanium plasma-sprayed, -blasted, and acid-etched implants [11]. The authors of this review explained that the oxidized surface provides a greater number of undercuts that may result in improved osseointegration.

In this retrospective cohort study, the clinical parameters in patients treated with anodized implants were evaluated to investigate the influence of antihypertensive medications on peri-implant tissues.


— Update: 04-01-2023 — cohaitungchi.com found an additional article Can I Get Dental Implants if I Have Existing Medical Conditions? from the website foothilldentalimplants.com for the keyword hypertension and dental implants.

Hypertension and dental implantsEvery Pasadena resident deserves to have a beautiful smile. If you’re missing teeth, dental implants can help restore your smile to its former glory. Getting dental implants is considered an oral surgery, though. Which begs the question, “Can I get dental implants if I have existing medical conditions?”

For the most part, if you are healthy enough to have regular dental treatment, then you are healthy enough to come to our Pasadena office to get dental implants. But, depending on the medical condition you have, certain precautions may need to be made.

Getting Dental Implants When You Have Hypertension

If you have hypertension, or high blood pressure, then certain considerations need to be made when placing your dental implants. This is because if you have high blood pressure, your body has to work harder to circulate blood. This process can become even more complicated by anxiety – something that is commonly experienced when having to undergo dental implant surgery or any oral surgery. Because of this, if you have high blood pressure, the doctors at Lytle, Tate & Stamper will provide you with the most appropriate level of sedation dentistry that you are comfortable with and that will not negatively interact with any blood pressure medications you may be taking, to reduce any surgery-related anxiety.

Getting Dental Implants When You Have Diabetes

If you have diabetes, then you likely already know that it takes your body longer to heal than the average, non-diabetic. So, does your delayed healing process exclude you from getting dental implants? Thankfully, the answer is no. Especially if your diabetes is under control by diet, exercise, medication or insulin, there’s no reason for you to expect that you will have complications when getting dental implants.

Getting Dental Implants When You Have Jawbone Tissue Loss

Many people who are missing teeth have lost them as a result of gum disease, or periodontitis. One of the common side effects of periodontitis is jawbone tissue loss, but in order to get dental implants, you need to have sufficient jawbone tissue so the titanium screw will fuse with your jawbone. So what are you to do if you’ve lost jawbone tissue to gum disease? Thankfully, an additional oral surgery called a jawbone graft can help regrow jawbone tissue in your mouth, making it possible for you to get dental implants. While a jawbone graft may delay your dental implants surgery for 6 months to a year, it is still entirely possible for you to repair your smile with dental implants.

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Getting Dental Implants When You Have Low Sinuses

If, when the doctors at our Pasadena office evaluate you, it’s determined that you have low sinuses, you may require a sinus lift surgery before you have implants placed in your upper jaw. This is to prevent the titanium screw portion of dental implants from interfering with your sinuses. While you’ll need to heal from your sinus lift surgery before you can have your dental implants placed, you will still be eligible for this permanent tooth replacement solution.

Learning More About Dental Implants

If you have additional questions about getting dental implants, including how other medical conditions might affect your eligibility for this tooth replacement solution, we encourage you to schedule an appointment at our Pasadena office to discuss your options. You can make an appointment today by calling (818) 240-1805.


— Update: 05-01-2023 — cohaitungchi.com found an additional article High Blood Pressure and Dental Implants from the website www.eonclinics.com for the keyword hypertension and dental implants.

Hypertension and dental implants

Hypertension, whether uncontrolled or managed well with medications, should be an important consideration in the treatment planning of any major tooth implant procedure. Dental implants are placed in the bone and do not have any effect on blood pressure, nor does the blood pressure have any effect on bone integration. However, blood pressure and medications taken to manage them can create harmful situations for patients who have not properly addressed their condition with their treating dentists.

Discussing High Blood Pressure & Medications With Your Dentist

A blood pressure reading is a measurement of how hard the body is working to push the blood out of the heart, through the body, and back into the heart. When more effort is required to circulate the blood the circulation is much less effective and less able to withstand increased heart activity during periods of anxiety. Very high blood pressure during a dental procedure involves a significant risk of stroke or kidney damage. Patients who take blood pressure medications to manage their hypertension are perfectly safe as long as they do not experience high levels of anxiety during their procedure. For this reason, pain management is critical in the implementation of planned tooth implant procedures.

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Medications should be taken to keep the blood pressure under control and analgesics should be delivered to manage pain and resulting anxiety but the combination of the two can actually cause the biggest issue for hypertensive patients undergoing dental implant procedures. The biggest mistake a hypertensive patient can make is failing to tell their dentist about the medications they are taking to control their blood pressure. Local anesthesia drugs such as epinephrine have more intense effects on the heart when combined with nonselective beta-blockers and can result in rapid increases to blood pressure which is exactly what the anesthesia was supposed to help avoid—pain, anxiety, and resulting higher blood pressure. The best way to effectively reduce pain and anxiety without aggravating the heart with a combination of medications is to deliver an adequate dosage of numbing agents spread out over more injections over a greater length of time. Though it may seem like the best way to limit the stress on the heart is to get the patient through the procedure quickly and allow them to begin to relax sooner, that just isn’t the case.

Dental Implant Care For Patients With High Blood Pressure

After the dental implant procedure there are also considerations for the post-operative recovery and healing period. Unmanaged high blood pressure limits the delivery of oxygen and nutrients to the veins and capillaries, which lowers their ability to regenerate and heal cells. Extended time with open wounds in the mouth increases risk of infection, swelling, and entry of harmful bacteria into the bloodstream.

Blood pressure managed by medication has very little impact on the progress of healing after tooth implant placement but still needs to be discussed between dentist and patient. Most implant procedures have an impressively quick recovery period and patients are able to resume normal activities without pain management within a few days. For those who need to take medication for discomfort for extended periods of time, they are at risk of decreased effectiveness with drug interactions. NSAIDS like Ibuprofen work against beta-blockers, alpha-blockers, vasodilators, ACE inhibitors, and diuretics when taken long enough. Again, this is most typically not a concern for a dental implant patient.

The bigger concern following tooth implant procedures is gum health and oral hygiene. Calcium channel blockers often cause the gums to become slightly swollen and overgrown which makes it more difficult to keep them clean. While implants and implant supported dentures are immune to cavities and gum disease, gum irritation can still be harmful and should be avoided to protect the integrity of the dental implant treatment.

The best way to prepare for the procedure of dental implants is to tell your dentist if you have high blood pressure or are keeping your blood pressure under control with medications. Your dentist will know how to keep you safe and comfortable during your procedure and educate you on proper care of your implants after your smile is restored.

References

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