Evidence Brief: Impact of Mental Health Conditions on Peri-implantitis and Dental Implant Failure
Parr NJ, Beech EH. Evidence Brief: Impact of Mental Health Conditions on Peri-implantitis and Dental Implant Failure. Washington, DC: Evidence Synthesis Program, Health Services Research and Development Service, Office of Research and Development, Department of Veterans Affairs. VA ESP Project #09-199; 2022.
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Moderate-strength evidence indicates that antidepressant use is likely associated with elevated risk of implant failure. Available evidence is insufficient to draw conclusions about the effect of mental health conditions on risk of implant failure, and no studies included peri-implantitis as an outcome of interest. Veteran implant candidates may benefit from approaches to screen for known and likely risk factors for implant failure, and from research on the effectiveness and feasibility of tailored peri-implant maintenance programs.
Dental implants are an increasingly common intervention to address missing or damaged teeth, but complications can occur and may ultimately result in loss of the implant. Research has suggested a link between dental implant failure and use of antidepressants. Additionally, depression or other mental health conditions may be associated with systematic and behavioral changes that could lead to oral inflammation and infections which, in turn, increase an implant recipient's risk of peri-implantitis and implant failure.
Evidence on the association between antidepressant use and implant failure risk is moderate strength and relies on observational studies of varying sizes and rigor. Antidepressant use at the time of implant placement likely increases risk of implant failure based on moderate-strength evidence from 9 studies (N = 25,364 implants). Evidence from only the most rigorous available studies indicates that antidepressant use at the time of implant placement is associated with an approximately 20% increase in risk of early implant failure. Available evidence is insufficient to draw conclusions about the effect of mental health conditions on risk of implant failure, and no studies included peri-implantitis as an outcome of interest.
Although antidepressant use alone may increase the risk of implant failure, many failures could be the result of a complex array of risk factors. Research is needed that would clarify relationships between mental health conditions, behavioral responses, and implant outcomes.