Impact of Antihypertensive, Antihyperlipidemic, and Mixed Antidepressant Medications on Dental Implant Success: A Retrospective Cohort Study

Objective: This study aimed to analyze the influence of antihypertensive, antihyperlipidemic, and mixed antidepressant medications on the failure and survival rates of dental implants. Methods: Out of a total of 2,815 patients who received 5,853 dental implants between 2012 and 2022, 655 patients with 2,004 implants met the inclusion criteria and were retrospectively reviewed. Patients were divided into four groups: control group (n = 512 patients with 1,581 implants), antihypertensive group (n₁ = 74 patients with 233 implants), antihyperlipidemic group (n₂ = 40 patients with 99 implants), and mixed antidepressant group (n₃ = 29 patients with 91 implants). Implant failure was defined according to the recommendations of the Pisa Consensus Conference of the International Congress of Oral Implantologists. Results: Kaplan-Meier analysis over a 10-year follow-up period showed significant differences in implant survival between the control group and all monotherapy groups. Implant survival was higher in patients receiving antihypertensive or antihyperlipidemic therapy and lower in those treated with mixed antidepressants. Log-rank tests confirmed statistically significant differences compared with controls (p < 0.05). Implant failure rates were 1.29% (n = 3/233) for the antihypertensive group, 1.01% (n = 1/99) for the antihyperlipidemic group, and 12.09% (n = 11/91) for the mixed antidepressant group, compared with 5.12% (n = 81/1581) in the control group. Mixed-effects survival analysis demonstrated a reduced risk of implant failure in patients receiving antihypertensive therapy (HR = 0.23) and antihyperlipidemic therapy (HR = 0.16), while mixed antidepressant medication was associated with a significantly increased risk of failure. Conclusion: Mixed antidepressant medications are associated with an increased risk of dental implant failure, while antihypertensive and antihyperlipidemic agents appear to have a protective effect, contributing to improved implant survival.