Perioperative Use of NSAIDs Might Impair Dental Implant Osseointegration

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 2x2 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: Nonwithstanding that a retrospective study design opens for potential bias, the current data indicate that dental implant osseointegration may be negatively affected 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