title: Perioperative use of non-steroidal anti-inflammatory drugs might impair dental implant osseointegration.
abstract: OBJECTIVE
  To appraise whether adverse biological events following oral implant placement may be associated with perioperative use of non-steroidal anti-inflammatory drugs (NSAIDs).
  
  
  METHODS
  All patients treated in a university faculty postgraduate dental clinic between 1979 and 2012 that had experienced a failing and surgically removed dental implant (292 implants in 168 patients) were contacted to solicit additional information about their present dental and medical status and frequency of current and past use of NSAIDs. Potential associations between perioperative NSAIDs use and the occurrence of adverse biological events were explored by the use of 2 × 2 tables and two-tailed Fisher's exact tests.
  
  
  RESULTS
  One hundred and four patients with initially 468 implants had experienced 238 implant failures, of which 197 were due to failing osseointegration (42%). Sixty of the participants, initially with 273 implants, had used NSAIDs perioperatively and experienced 44% implant failures, versus 38% in the non-NSAID cohort. The NSAID cohort experienced 3.2 times more cases of radiographic bone loss greater than 30% of the vertical height of their remaining implants and 1.9 times more cases of cluster failures, defined as failure of 50% or more of the implant(s) placed.
  
  
  CONCLUSIONS
  Notwithstanding that a retrospective study design is open to potential bias, the current data indicate that dental implant osseointegration may be affected negatively by an inhibitory effect of NSAIDs on bone healing in vulnerable patients. Future and better clinical studies than the current should be designed to appraise more precisely the potential effects of NSAIDs on implant osseointegration in study populations that are not limited by stringent medical inclusion and exclusion criteria.
authors.affiliation: Department of Prosthodontics, Faculty of Dentistry, University of Toronto, Toronto, ON, Canada.
authors.forename: Brent
authors.initials: B
authors.lastname: Winnett
authors.affiliation: Discipline of Periodontology, University of Toronto, Toronto, ON, Canada.|Department of Periodontics, School of Dentistry, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Howard C
authors.initials: HC
authors.lastname: Tenenbaum
authors.affiliation: Matrix Dynamics, University of Toronto, Toronto, ON, Canada.
authors.forename: Ben
authors.initials: B
authors.lastname: Ganss
authors.affiliation: Department of Prosthodontics, Faculty of Dentistry, University of Toronto, Toronto, ON, Canada.|University of Tromsø Faculty of health Sciences, Clinical Dentistry, Tromsø, Norway.
authors.forename: Asbjørn
authors.initials: A
authors.lastname: Jokstad
mesh_terms: D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects*; D015921:Dental Implants; D019232:Dental Restoration Failure; D020878:Device Removal; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016348:Osseointegration / Q000187:drug effects*; D010149:Postoperative Pain / Q000517:prevention & control*; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D015921:Dental Implants
keywords: bone implant interactions; clinical research; patient centered outcomes; soft tissue-implant interactions; wound healing