Antihipertansif İlaçların Dental İmplant Stabilitesi ve İmplant Çevresi Sağlığı Üzerindeki Etkisi: Retrospektif Kohort Çalışması
Öz
Amaç: Bu çalışmanın amacı, antihipertansif ilaç kullanan bireyler ile normotansif bireyler arasında implant stabilitesini (rezonans frekans analizi ile ölçülen) ve klinik parametreleri (sondalamada kanama ve radyografik kemik kaybı) karşılaştırmaktır.
Materyal ve Metot: Retrospektif kohort tasarımı ile gerçekleştirilen bu çalışmaya toplam 265 implant yerleştirilen 50 katılımcı dahil edilmiştir. Primer (ISQ-1) ve sekonder (ISQ-2) stabilite için RFA ölçümleri yapılmış ve klinik parametreler değerlendirilmiştir. Kohort, antihipertansif ilaç kullananlar ve normotansif bireyler olmak üzere iki gruba ayrılmıştır.
Bulgular: Antihipertansif kullanan bireylerde ISQ-1 (ortalama: 78.9, SD: 6.0) ve ISQ-2 (ortalama: 82.9, SD: 4.6) değerleri kontrol grubuna kıyasla (ISQ-1 ortalama: 72.3, SD: 5.2; ISQ-2 ortalama: 80.4, SD: 3.9) anlamlı derecede yüksekti (p<0.001). Sondalamada kanama oranı antihipertansif kullanan grupta daha yüksek (%25.9) bulunurken, kontrol grubunda bu oran %22.4 olarak tespit edilmiştir (p<0.001). Radyografik kemik kaybı açısından ise gruplar arasında anlamlı bir fark bulunmamıştır (antihipertansif: 0.99 mm, SD: 0.7; kontrol: 0.96 mm, SD: 0.5; p=0.733).
Sonuç: Antihipertansif ilaç kullanan bireylerde implant stabilitesi daha yüksek bulunmuş olup, bu ilaçların osseointegrasyon süreci üzerinde olumlu etkileri olabileceği düşünülmektedir. Ancak, sondalamada kanama oranındaki artış peri-implant inflamasyon riskine işaret edebilir. Daha geniş örneklemlerle prospektif çalışmalar yapılması önerilmektedir.
Anahtar Kelimeler
Antihipertansif İlaçlar Diş İmplantları Kemik Yoğunluğu Hipertansiyon Osseointegrasyon
Etik Beyan
Bu çalışma için Marmara Üniversitesi Sağlık Bilimleri Fakültesi Etik Komitesi tarafından etik onay alınmıştır (Onay Numarası: 04.10.2022/84)
Destekleyen Kurum
Katkılarından ötürü Marmara Üniversitesi Ağız Diş ve Çene Cerrahisi ABD'na teşekkür ederiz
Teşekkür
Araştırmamızda istatistiklerin değerlendirilmesi ve sonuçların incelenmesinde katkılarından dolayı Dr.Ferit Bayram'a teşekkür ederiz.
Kaynakça
- Ağaçayak, K. S., S. Güven, M. Koparal, N. Güneş, Y. AtalayS. Atılgan. Long-term effects of antihypertensive medications on bone mineral density in men older than 55 years. Clin Interv Aging. 2014; 9 (1): 509-513.
- Chobanian, A. V., G. L. Bakris, H. R. Black, W. C. Cushman, L. A. Green, J. L. Izzo, Jr. ve ark. Seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Hypertension. 2003; 42 (6): 1206-1252.
- Dinc, G., K. Sozmen, G. Gerceklioglu, H. Arik, J. CritchleyB. Unal. Decreasing trends in cardiovascular mortality in Turkey between 1988 and 2008. BMC Public Health. 2013; 13 896.
- Ettehad, D., C. A. Emdin, A. Kiran, S. G. Anderson, T. Callender, J. Emberson ve ark. Blood pressure lowering for prevention of cardiovascular disease and death: a systematic review and meta-analysis. Lancet. 2016; 387 (10022): 957-967.
- Garcia-Denche, J. T., X. Wu, P. P. Martinez, H. Eimar, D. J. Ikbal, G. Hernandez ve ark. Membranes over the lateral window in sinus augmentation procedures: a two-arm and split-mouth randomized clinical trials. J Clin Periodontol. 2013; 40 (11): 1043-1051.
- Ghosh, M.S. R. Majumdar. Antihypertensive medications, bone mineral density, and fractures: a review of old cardiac drugs that provides new insights into osteoporosis. Endocrine. 2014; 46 (3): 397-405.
- Gupta, A. K., S. ArshadN. R. Poulter. Compliance, safety, and effectiveness of fixed-dose combinations of antihypertensive agents: a meta-analysis. Hypertension. 2010; 55 (2): 399-407.
- Gutmacher, Z., E. E. Machtei, I. Hirsh, H. Zigdon-GiladiJ. Horwitz. A comparative study on the use of digital panoramic and periapical radiographs to assess proximal bone height around dental implants. Quintessence Int. 2016; 47 (5): 441-446.
- Herrero-Climent, M., R. Santos-Garcia, R. Jaramillo-Santos, M. M. Romero-Ruiz, A. Fernandez-Palacin, P. Lazaro-Calvo ve ark. Assessment of Osstell ISQ's reliability for implant stability measurement: a cross-sectional clinical study. Med Oral Patol Oral Cir Bucal. 2013; 18 (6): e877-882.
- Huang, H. M., C. L. Chiu, C. Y. Yeh, C. T. Lin, L. H. LinS. Y. Lee. Early detection of implant healing process using resonance frequency analysis. Clin Oral Implants Res. 2003; 14 (4): 437-443.
- Mancia, G., G. De Backer, A. Dominiczak, R. Cifkova, R. Fagard, G. Germano ve ark. 2007 Guidelines for the management of arterial hypertension: The Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). Eur Heart J. 2007; 28 (12): 1462-1536.
- Mills, K. T., J. D. Bundy, T. N. Kelly, J. E. Reed, P. M. Kearney, K. Reynolds ve ark. Global Disparities of Hypertension Prevalence and Control: A Systematic Analysis of Population-Based Studies From 90 Countries. Circulation. 2016; 134 (6): 441-450.
- Mills, K. T., A. StefanescuJ. He. The global epidemiology of hypertension. Nat Rev Nephrol. 2020; 16 (4): 223-237.
- Misch, C. E., M. L. Perel, H. L. Wang, G. Sammartino, P. Galindo-Moreno, P. Trisi ve ark. Implant success, survival, and failure: the International Congress of Oral Implantologists (ICOI) Pisa Consensus Conference. Implant Dent. 2008; 17 (1): 5-15.
- Mishra, S. K., N. K. SonnahalliR. Chowdhary. Do antihypertensive medications have an effect on dental implants? A systematic review. Oral Maxillofac Surg. 2024; 28 (2): 459-468.
- Muller-Nordhorn, J., S. Binting, S. RollS. N. Willich. An update on regional variation in cardiovascular mortality within Europe. Eur Heart J. 2008; 29 (10): 1316-1326.
- Qaseem, A., T. J. Wilt, R. Rich, L. L. Humphrey, J. Frost, M. A. Forciea ve ark. Pharmacologic Treatment of Hypertension in Adults Aged 60 Years or Older to Higher Versus Lower Blood Pressure Targets: A Clinical Practice Guideline From the American College of Physicians and the American Academy of Family Physicians. Ann Intern Med. 2017; 166 (6): 430-437.
- Quesada-Garcia, M. P., E. Prados-Sanchez, M. V. Olmedo-Gaya, E. Munoz-Soto, M. P. Gonzalez-RodriguezM. Valllecillo-Capilla. Measurement of dental implant stability by resonance frequency analysis: a review of the literature. Med Oral Patol Oral Cir Bucal. 2009; 14 (10): e538-546.
- Rejnmark, L., P. VestergaardL. Mosekilde. Treatment with beta-blockers, ACE inhibitors, and calcium-channel blockers is associated with a reduced fracture risk: a nationwide case-control study. J Hypertens. 2006; 24 (3): 581-589.
- Rodrigo, D., L. Aracil, C. MartinM. Sanz. Diagnosis of implant stability and its impact on implant survival: a prospective case series study. Clin Oral Implants Res. 2010; 21 (3): 255-261.
- Saravi, B., A. Vollmer, G. Lang, N. Adolphs, Z. Li, V. Giers ve ark. Impact of renin-angiotensin system inhibitors and beta-blockers on dental implant stability. Int J Implant Dent. 2021; 7 (1): 31.
- Satheesh, G., R. Dhurjati, M. D. Huffman, A. Rosende, A. Rodgers, D. Prabhakaran ve ark. Standardized treatment protocols for hypertension: global availability, characteristics, and alignment with the hypertension guideline recommendations. J Hypertens. 2024; 42 (5): 902-908.
- Schulte, W., B. d'Hoedt, D. Lukas, L. Muhlbradt, F. Scholz, J. Bretschi ve ark. [Periotest--a new measurement process for periodontal function]. Zahnarztl Mitt. 1983; 73 (11): 1229-1230, 1233-1226, 1239-1240.
- Seki, K., A. Hasuike, Y. IwanoY. Hagiwara. Influence of antihypertensive medications on the clinical parameters of anodized dental implants: a retrospective cohort study. Int J Implant Dent. 2020; 6 (1): 32.
- Strampelli, A., F. CerretaK. Vucic. Medication use among older people in Europe: Implications for regulatory assessment and co-prescription of new medicines. Br J Clin Pharmacol. 2020; 86 (10): 1912-1920.
- Turnbull, F.C. Blood Pressure Lowering Treatment Trialists. Effects of different blood-pressure-lowering regimens on major cardiovascular events: results of prospectively-designed overviews of randomised trials. Lancet. 2003; 362 (9395): 1527-1535.
- Wu, X., K. Al-Abedalla, H. Eimar, S. Arekunnath Madathil, S. Abi-Nader, N. G. Daniel ve ark. Antihypertensive Medications and the Survival Rate of Osseointegrated Dental Implants: A Cohort Study. Clin Implant Dent Relat Res. 2016; 18 (6): 1171-1182.
- Xie, X., E. Atkins, J. Lv, A. Bennett, B. Neal, T. Ninomiya ve ark. Effects of intensive blood pressure lowering on cardiovascular and renal outcomes: updated systematic review and meta-analysis. Lancet. 2016; 387 (10017): 435-443.
- Zhang, R., H. Yin, M. Yang, X. Lei, D. ZhenZ. Zhang. Advanced Progress of the Relationship Between Antihypertensive Drugs and Bone Metabolism. Hypertension. 2023; 80 (11): 2255-2264.
Effect of Antihypertensive Drugs on Dental Implant Stability and Peri-Implant Health: Retrospective Cohort Study
Öz
Objective: The aim of this study was to compare implant stability (measured by resonance frequency analysis) and clinical parameters (bleeding on probing and radiographic bone loss) between individuals using antihypertensive medication and normotensive individuals.
Materials and Methods: A total of 265 50 participants who received implants were included. RFA measurements were performed for primary (ISQ-1) and secondary (ISQ-2) stability and clinical parameters were evaluated. The cohort was divided into two groups: those using antihypertensive drugs and normotensive individuals.
Results: ISQ-1 in individuals using antihypertensive drugs (mean: 78.9, SD: 6.0) and ISQ-2 (mean: 82.9, SD: 4.6) values were significantly higher compared to the control group (ISQ-1 mean: 72.3, SD: 5.2; ISQ-2 mean: 80.4, SD: 3.9) (p< The rate of bleeding on probing was found to be higher in the antihypertensive group (25.9%), while this rate was found to be 22.4% in the control group (p<0.001). There was no significant difference between the groups in terms of radiographic bone loss (antihypertensive: 0.99 mm, SD: 0.7; control: 0.96 mm, SD: 0.5; p=0.733).
Conclusion: Implant stability was found to be higher in individuals using antihypertensive drugs, and It is thought that it may have positive effects on the osseointegration process. However, an increase in the rate of bleeding on probing may indicate a risk of peri-implant inflammation. Prospective studies with larger samples are recommended.
Anahtar Kelimeler
Antihypertensive Agents Dental Implants Bone Density Hypertension Osseointegration
Kaynakça
- Ağaçayak, K. S., S. Güven, M. Koparal, N. Güneş, Y. AtalayS. Atılgan. Long-term effects of antihypertensive medications on bone mineral density in men older than 55 years. Clin Interv Aging. 2014; 9 (1): 509-513.
- Chobanian, A. V., G. L. Bakris, H. R. Black, W. C. Cushman, L. A. Green, J. L. Izzo, Jr. ve ark. Seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Hypertension. 2003; 42 (6): 1206-1252.
- Dinc, G., K. Sozmen, G. Gerceklioglu, H. Arik, J. CritchleyB. Unal. Decreasing trends in cardiovascular mortality in Turkey between 1988 and 2008. BMC Public Health. 2013; 13 896.
- Ettehad, D., C. A. Emdin, A. Kiran, S. G. Anderson, T. Callender, J. Emberson ve ark. Blood pressure lowering for prevention of cardiovascular disease and death: a systematic review and meta-analysis. Lancet. 2016; 387 (10022): 957-967.
- Garcia-Denche, J. T., X. Wu, P. P. Martinez, H. Eimar, D. J. Ikbal, G. Hernandez ve ark. Membranes over the lateral window in sinus augmentation procedures: a two-arm and split-mouth randomized clinical trials. J Clin Periodontol. 2013; 40 (11): 1043-1051.
- Ghosh, M.S. R. Majumdar. Antihypertensive medications, bone mineral density, and fractures: a review of old cardiac drugs that provides new insights into osteoporosis. Endocrine. 2014; 46 (3): 397-405.
- Gupta, A. K., S. ArshadN. R. Poulter. Compliance, safety, and effectiveness of fixed-dose combinations of antihypertensive agents: a meta-analysis. Hypertension. 2010; 55 (2): 399-407.
- Gutmacher, Z., E. E. Machtei, I. Hirsh, H. Zigdon-GiladiJ. Horwitz. A comparative study on the use of digital panoramic and periapical radiographs to assess proximal bone height around dental implants. Quintessence Int. 2016; 47 (5): 441-446.
- Herrero-Climent, M., R. Santos-Garcia, R. Jaramillo-Santos, M. M. Romero-Ruiz, A. Fernandez-Palacin, P. Lazaro-Calvo ve ark. Assessment of Osstell ISQ's reliability for implant stability measurement: a cross-sectional clinical study. Med Oral Patol Oral Cir Bucal. 2013; 18 (6): e877-882.
- Huang, H. M., C. L. Chiu, C. Y. Yeh, C. T. Lin, L. H. LinS. Y. Lee. Early detection of implant healing process using resonance frequency analysis. Clin Oral Implants Res. 2003; 14 (4): 437-443.
- Mancia, G., G. De Backer, A. Dominiczak, R. Cifkova, R. Fagard, G. Germano ve ark. 2007 Guidelines for the management of arterial hypertension: The Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). Eur Heart J. 2007; 28 (12): 1462-1536.
- Mills, K. T., J. D. Bundy, T. N. Kelly, J. E. Reed, P. M. Kearney, K. Reynolds ve ark. Global Disparities of Hypertension Prevalence and Control: A Systematic Analysis of Population-Based Studies From 90 Countries. Circulation. 2016; 134 (6): 441-450.
- Mills, K. T., A. StefanescuJ. He. The global epidemiology of hypertension. Nat Rev Nephrol. 2020; 16 (4): 223-237.
- Misch, C. E., M. L. Perel, H. L. Wang, G. Sammartino, P. Galindo-Moreno, P. Trisi ve ark. Implant success, survival, and failure: the International Congress of Oral Implantologists (ICOI) Pisa Consensus Conference. Implant Dent. 2008; 17 (1): 5-15.
- Mishra, S. K., N. K. SonnahalliR. Chowdhary. Do antihypertensive medications have an effect on dental implants? A systematic review. Oral Maxillofac Surg. 2024; 28 (2): 459-468.
- Muller-Nordhorn, J., S. Binting, S. RollS. N. Willich. An update on regional variation in cardiovascular mortality within Europe. Eur Heart J. 2008; 29 (10): 1316-1326.
- Qaseem, A., T. J. Wilt, R. Rich, L. L. Humphrey, J. Frost, M. A. Forciea ve ark. Pharmacologic Treatment of Hypertension in Adults Aged 60 Years or Older to Higher Versus Lower Blood Pressure Targets: A Clinical Practice Guideline From the American College of Physicians and the American Academy of Family Physicians. Ann Intern Med. 2017; 166 (6): 430-437.
- Quesada-Garcia, M. P., E. Prados-Sanchez, M. V. Olmedo-Gaya, E. Munoz-Soto, M. P. Gonzalez-RodriguezM. Valllecillo-Capilla. Measurement of dental implant stability by resonance frequency analysis: a review of the literature. Med Oral Patol Oral Cir Bucal. 2009; 14 (10): e538-546.
- Rejnmark, L., P. VestergaardL. Mosekilde. Treatment with beta-blockers, ACE inhibitors, and calcium-channel blockers is associated with a reduced fracture risk: a nationwide case-control study. J Hypertens. 2006; 24 (3): 581-589.
- Rodrigo, D., L. Aracil, C. MartinM. Sanz. Diagnosis of implant stability and its impact on implant survival: a prospective case series study. Clin Oral Implants Res. 2010; 21 (3): 255-261.
- Saravi, B., A. Vollmer, G. Lang, N. Adolphs, Z. Li, V. Giers ve ark. Impact of renin-angiotensin system inhibitors and beta-blockers on dental implant stability. Int J Implant Dent. 2021; 7 (1): 31.
- Satheesh, G., R. Dhurjati, M. D. Huffman, A. Rosende, A. Rodgers, D. Prabhakaran ve ark. Standardized treatment protocols for hypertension: global availability, characteristics, and alignment with the hypertension guideline recommendations. J Hypertens. 2024; 42 (5): 902-908.
- Schulte, W., B. d'Hoedt, D. Lukas, L. Muhlbradt, F. Scholz, J. Bretschi ve ark. [Periotest--a new measurement process for periodontal function]. Zahnarztl Mitt. 1983; 73 (11): 1229-1230, 1233-1226, 1239-1240.
- Seki, K., A. Hasuike, Y. IwanoY. Hagiwara. Influence of antihypertensive medications on the clinical parameters of anodized dental implants: a retrospective cohort study. Int J Implant Dent. 2020; 6 (1): 32.
- Strampelli, A., F. CerretaK. Vucic. Medication use among older people in Europe: Implications for regulatory assessment and co-prescription of new medicines. Br J Clin Pharmacol. 2020; 86 (10): 1912-1920.
- Turnbull, F.C. Blood Pressure Lowering Treatment Trialists. Effects of different blood-pressure-lowering regimens on major cardiovascular events: results of prospectively-designed overviews of randomised trials. Lancet. 2003; 362 (9395): 1527-1535.
- Wu, X., K. Al-Abedalla, H. Eimar, S. Arekunnath Madathil, S. Abi-Nader, N. G. Daniel ve ark. Antihypertensive Medications and the Survival Rate of Osseointegrated Dental Implants: A Cohort Study. Clin Implant Dent Relat Res. 2016; 18 (6): 1171-1182.
- Xie, X., E. Atkins, J. Lv, A. Bennett, B. Neal, T. Ninomiya ve ark. Effects of intensive blood pressure lowering on cardiovascular and renal outcomes: updated systematic review and meta-analysis. Lancet. 2016; 387 (10017): 435-443.
- Zhang, R., H. Yin, M. Yang, X. Lei, D. ZhenZ. Zhang. Advanced Progress of the Relationship Between Antihypertensive Drugs and Bone Metabolism. Hypertension. 2023; 80 (11): 2255-2264.
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Konular | Ağız ve Çene Cerrahisi |
| Bölüm | Özgün Araştırmalar |
| Yazarlar | |
| Yayımlanma Tarihi | 30 Nisan 2025 |
| Gönderilme Tarihi | 16 Şubat 2025 |
| Kabul Tarihi | 3 Mart 2025 |
| Yayımlandığı Sayı | Yıl 2025 Cilt: 9 Sayı: 1 |
