Impact of proton pump inhibitors on periodontal health – A systematic review

IF 1.7 Q3 DENTISTRY, ORAL SURGERY & MEDICINE Saudi Dental Journal Pub Date : 2024-08-02 DOI:10.1016/j.sdentj.2024.07.017
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Abstract

Introduction

In recent times, proton pump inhibitors (PPI) are frequently prescribed to manage acid reflux and to aid in completion of course of medication, which cause gastric irritation. Although this practice may minimize compliance to drug therapies and probably prevent development of drug resistance, the adverse effects of chronic PPI use have to be assessed. Inadvertent chronic use of PPIs has been found to inhibit normal gastrointestinal microbiome and even bone metabolism. The current study aimed to review available evidence based literature to understand the beneficial effects of PPIs weighed against their adversities with respect to periodontal and peri-implant health.

Materials and Methods

The search strategy was followed according to the PRISMA guidelines for systematic reviews. Proton pump inhibitors, periodontal disease, dental implant (DI) and bone osseointegration were used as key MESH terms to search and select the required articles for review. While primary inclusion criteria were original researches, published in English, between 2014 to till-date, case reports, reviews and editorial communications were excluded.

Results

The overall search strategy resulted in 445 articles. Applying the inclusion and exclusion criteria 37 articles were selected. Scrutinizing the abstracts for relevance, 17 publications were finally selected for review. This included three in vivo animal studies evaluating DI osseointegration and 14 retrospective clinical studies (nine in patients with dental implants, four in patients with periodontitis and one evaluating bone quality using panoramic radiographs).

Conclusion

Findings from this systematic review revealed a plausible relationship between chronic PPI use and poor peri-implant bone health leading to early DI failure, and mandibular osteoporotic changes. On the contrary, use of PPI among patients with periodontitis, resulted in an improvement in periodontal health and reduction in periodontal disease severity.

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质子泵抑制剂对牙周健康的影响--系统综述
导言:近来,质子泵抑制剂(PPI)经常被用于控制胃酸倒流和帮助完成对胃有刺激作用的药物疗程。虽然这种做法可以最大限度地减少对药物疗法的依从性,并可能防止耐药性的产生,但必须对长期使用质子泵抑制剂的不良影响进行评估。研究发现,无意中长期使用 PPIs 会抑制正常的胃肠道微生物群,甚至会影响骨代谢。本研究旨在回顾现有的循证文献,以了解 PPIs 对牙周和种植体周围健康的有利影响和不利影响。将质子泵抑制剂、牙周病、牙种植体(DI)和骨结合作为关键 MESH 术语进行搜索,并选择所需的文章进行综述。主要纳入标准为 2014 年至今用英语发表的原创性研究文章,病例报告、综述和编辑通讯则被排除在外。根据纳入和排除标准,共筛选出 37 篇文章。在对摘要进行相关性审查后,最终选择了 17 篇文章进行审查。其中包括三项评估 DI 骨整合的体内动物研究和 14 项回顾性临床研究(九项针对牙科植入物患者,四项针对牙周炎患者,一项使用全景 X 光片评估骨质)。相反,牙周炎患者使用 PPI 可改善牙周健康,减轻牙周疾病的严重程度。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Saudi Dental Journal
Saudi Dental Journal DENTISTRY, ORAL SURGERY & MEDICINE-
CiteScore
3.60
自引率
0.00%
发文量
86
审稿时长
22 weeks
期刊介绍: Saudi Dental Journal is an English language, peer-reviewed scholarly publication in the area of dentistry. Saudi Dental Journal publishes original research and reviews on, but not limited to: • dental disease • clinical trials • dental equipment • new and experimental techniques • epidemiology and oral health • restorative dentistry • periodontology • endodontology • prosthodontics • paediatric dentistry • orthodontics and dental education Saudi Dental Journal is the official publication of the Saudi Dental Society and is published by King Saud University in collaboration with Elsevier and is edited by an international group of eminent researchers.
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