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

ABSTRACT: BACKGROUND:Hypertension is a chronic medical condition in which blood pressure in the arteries is elevated. Given the large proportion of dental implant patients using antihypertensive medications, it is crucial to evaluate the effects of these drugs on the clinical parameters of osseointegrated implants. The aim of the present retrospective cohort study was to evaluate the influence of antihypertensive medications on clinical peri-implant tissue parameters. METHODS:Thirty-five patients received a total of 77 anodized dental implants. Based on the history of the use of antihypertensive medications, the patients were divided into two groups: the group taking antihypertensive medications (AH group) and the group of healthy patients (H group). Implants were followed up clinically and radiologically, with a focus on the peri-implant soft tissue parameters probing pocket depth, bleeding on probing, modified plaque index, and marginal peri-implant bone level stability. RESULTS:None of the implants were lost, and no technical failures occurred. The mean follow-up duration was 7?years and 1?month. A significant difference was observed in the probing pocket depth 3.8 ± 1.3?mm in the AH group and 3.0 ± 0.7?mm in the H group. In the AH and H groups, 26.5% (9/34) and 4.7% (2/43) of the patients were diagnosed with peri-implantitis at the implant level, respectively. CONCLUSIONS:Our findings suggest some correlations between antihypertensive medication use and clinical parameters in anodized peri-implant tissue.

SUBMITTER: Seki K

PROVIDER: S-EPMC7374550 | biostudies-literature | 2020 Sep

REPOSITORIES: biostudies-literature

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

Seki Keisuke K Hasuike Akira A Iwano Yoshihiro Y Hagiwara Yoshiyuki Y

International journal of implant dentistry 20200916 1

<h4>Background</h4>Hypertension is a chronic medical condition in which blood pressure in the arteries is elevated. Given the large proportion of dental implant patients using antihypertensive medications, it is crucial to evaluate the effects of these drugs on the clinical parameters of osseointegrated implants. The aim of the present retrospective cohort study was to evaluate the influence of antihypertensive medications on clinical peri-implant tissue parameters.<h4>Methods</h4>Thirty-five pa ...[more]

PMID: 32696295

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Project description:BackgroundThe majority of people with hypertension require more than one medication to achieve blood pressure control. Many patients are prescribed multipill antihypertensive regimens rather than single-pill fixed-dose combination (FDC) treatment. Although FDC use may improve medication adherence, the impact on patient outcomes is unclear. We compared clinical outcomes and medication adherence with FDC therapy versus multipill combination therapy in a real-world setting using linked clinical and administrative databases.Methods and findingsWe conducted a population-based retrospective cohort study of 13,350 individuals 66 years and older in Ontario, Canada with up to 5 years of follow-up. We included individuals who were newly initiated on one angiotensin-converting enzyme inhibitor (ACEI) or angiotensin II-receptor blocker (ARB) plus one thiazide diuretic. High-dimensional propensity score matching was used to compare individuals receiving FDC versus multipill therapy. The primary outcome was a composite of death or hospitalization for acute myocardial infarction (AMI), heart failure, or stroke. We conducted 2 analyses to examine the association between adherence and patient outcomes. First, we performed an on-treatment analysis to determine whether outcomes differed between groups while patients were on treatment, censoring patients when they first discontinued treatment, defined as not receiving medications within 150% of the previous days' supply. Second, we conducted an intention-to-treat analysis that followed individuals allowing for breaks in treatment to quantify the difference in drug adherence between groups and assess its impact on clinical outcomes. As expected, there was no significant difference in the primary outcome between groups in the on-treatment analysis (HR 1.06, 95% CI 0.86-1.31, P = 0.60). In the intention-to-treat analysis, the proportion of total follow-up days covered with medications was significantly greater in the FDC group (70%; IQR 19-98) than in the multipill group (42%, IQR 11-91, P < 0.01), and the primary outcome was less frequent in FDC recipients (3.4 versus 3.9 events per 100 person-years; HR 0.89, 95% CI 0.81-0.97, P < 0.01). The main limitations of this study were the lack of data regarding cause of death and blood pressure measurements and the possibility of residual confounding.ConclusionsAmong older adults initiating combination antihypertensive treatment, FDC therapy was associated with a significantly lower risk of composite clinical outcomes, which may be related to better medication adherence.

Project description:AbstractMedication nonadherence represents a modifiable risk factor for patients with hypertension. Identification of nonadherent patients could have significant clinical and economic implications in the management of uncontrolled hypertension.We analysed the results of 174 urinary adherence screens from patients referred to Addenbrooke's Hospital, Cambridge, for uncontrolled hypertension. Cases were identified for evaluation by results of liquid chromatography-tandem mass spectrometry of urine samples (males: 91; females: 83; age range: 17-87). We performed a binary logistic regression analysis for nonadherence using age, sex, and number of medications prescribed (both antihypertensives and non-antihypertensives separately) as independent predictors. Rates of nonadherence for individual antihypertensive drugs were calculated if prescribed to ≥10 patients.The overall rate of nonadherence to one or more prescribed antihypertensive medications was 40.3%. 14.4% of all patients were nonadherent to all prescribed antihypertensive medications (complete nonadherence), whereas 25.9% of all patients were nonadherent to at least 1, (but not all) prescribed antihypertensive medications (partial nonadherence). 72% of patients were prescribed ≥3 antihypertensives And for every increase in the number of antihypertensive medications prescribed, nonadherence increased with adjusted odds ratios of 2.9 (P < .001). Logistic regression showed that women were 3.3 times more likely to be nonadherent (P = .004). Polypharmacy (≥6 medications prescribed for hypertension and/or concomitant comorbidities) was prevalent in 52%. Bendroflumethiazide and chlortalidone demonstrated the highest and lowest nonadherences respectively (45.5% and 11.8%).Rate of nonadherence in patients with hypertension was significantly impacted by sex and number of antihypertensive medications prescribed. Understanding these factors is crucial in identifying and managing nonadherence.

Project description:The available data on gender differences in clinical migraine parameters among pediatric patients are based on relatively few studies, which did not use the current version of the International Classification of Headache Disorders (ICHD) of the International Headache Society. The aim of the present study was to compare between males and females, demographic and clinical characteristics of children and adolescents with migraines diagnosed according to the ICDIII-beta version.The electronic database of a tertiary pediatric headache clinic was searched for all children and adolescents diagnosed with migraine headaches in 2010-2016. Data on demographics, symptoms, and headache-related parameters were collected from the medical files. Findings were compared by gender.The cohort included 468 children and adolescents of mean age 11.3 ± 3.6 years; 215 males (45.9%) and 253 females (54.1%). Migraine without aura was documented in 313 patients (66.9%), and migraine with aura in 127 (27.1%); 28 patients (6.0%) had probable migraines. The female patients had significantly higher values than the male patients for the following parameters: age at admission (p = 0.042, Cohen's d 0.8303, 95% CI 0.614-0.992); age at migraine onset (p = 0.021, Cohen's d 0.211, 95% CI 0.029-0.394); rate of migraine with aura (OR 2.01, 95% CI 1.29-3.16, p = 0.0056); headache frequency (p = 0.0149, Cohen's d 0.211, 95% CI 0.029-0.3940); rate of chronic migraine (p = 0.036, OR 1.54, 95% CI 1.02-2.34); and puberty (OR 3.51, 95% CI 2.01-6.35, p = <0.001). Males had a higher rate of vomiting (OR 0.62, 95% CI 0.41-0.93, p = 0.018). Further analysis by pubertal stage revealed that pubertal females, but not prepubertal females, had a significantly higher rate of migraine with aura than did males (41.1% versus 28.9%; OR 1.42, 95% CI 0.85-2.37, p = 0.039).Female children and adolescents with migraine treated in a tertiary pediatric headache clinic were characterized by a higher rate of chronic migraine and migraine with aura, a lower rate of vomiting, and older age at onset relative to males. These findings might be influenced by the better description of migraine symptoms by females owing to their better verbal ability.

Project description:There is no consensus in the literature about the best non-cytotoxic antibacterial surface treatment for dental implants. Critically evaluate the existing literature and answer the question: "which surface treatment for dental implants made of titanium and its alloys has the greatest non-cytotoxic antibacterial activity for osteoblastic cells?" This systematic review was registered in the Open Science Framework (osf.io/8fq6p) and followed the Preferred Reporting Items for Systematic Review and Meta-analysis Protocols. The search strategy was applied to four databases. Articles were selected that evaluated in both studies the properties of 1) antibacterial activity and 2) cytotoxicity on osteoblastic cells of titanium and their alloy dental implants when treated superficially. Systematic reviews, book chapters, observational studies, case reports, articles that studied non-dental implants, and articles that evaluated only the development of surface treatment were excluded. The Joanna Briggs Institute, a quasi-experimental study assessment tool, was adapted to assess the risk of bias. The search strategy found 1178 articles in the databases after removing duplicates in EndNote Web, resulting in 1011 articles to be evaluated by title and abstract, of which 21 were selected for full reading, of which 12 were included by eligibility criteria, and nine were excluded. Quantitative synthesis could not be performed due to the heterogeneity of the data (surface treatment, antibacterial assay, bacteria strain, cell viability assay, and cell type). Risk of bias assessment showed that ten studies were classified as low risk and two studies as moderate risk. The evaluated literature allowed us to conclude that: 1) The literature surveyed did not allow answering the question due to the heterogeneity of the studies; 2) Ten of the 12 studies evaluated presented surface treatments with non-cytotoxic antibacterial activity; 3) Adding nanomaterials, QPEI, BG, and CS, reduce the chances of bacterial resistance by controlling their adhesion by electrical forces.

Dataset Information

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

Publications

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

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