Effects of Drugs and Chemotherapeutic Agents on Dental Implant Osseointegration: Narrative Review.

BACKGROUND: Dental implants have been one of the most popular treatments for rehabilitating individuals with single missing teeth or fully edentulous jaws since their introduction. As more implant patients are well-aged and take several medications due to various systemic conditions, clinicians should be mindful of possible drug implications on bone remodeling and osseointegration. OBJECTIVE: The present study aims to study and review some desirable and some unwelcomed implications of medicine on osseointegration. METHODS: A broad search for proper relevant studies were conducted in four databases, including Web of Science, Pubmed, Scopus, and Google Scholar. RESULTS: Some commonly prescribed medicines such as nonsteroidal anti-inflammatory drugs (NSAIDs), glucocorticoids, proton pump inhibitors (PPIs), selective serotonin reuptake inhibitors (SSRIs), anticoagulants, metformin, and chemotherapeutic agents may jeopardize osseointegration. On the contrary, some therapeutic agents such as anabolic, anti-catabolic, or dual anabolic and anti-catabolic agents may enhance osseointegration and increase the treatment's success rate. CONCLUSION: Systemic medications that enhance osseointegration include mineralization promoters and bone resorption inhibitors. On the other hand, medications often given to the elderly with systemic problems might interfere with osseointegration, leading to implant failure. However, to validate the provided research, more human studies with a higher level of evidence are required.

Genotyping of Pseudomonas Aeruginosa Strains As A Multidrug Resistant (MDR) Bacterium And Evaluating The Prevalence of Esbls and Some Virulence Factors Encoding Genes By PFGE and ERIC-PCR Methods.

Pseudomonas aeruginosa is an important multi-drug resistant (MDR) opportunistic bacterium. 102 strains of Pseudomonas aeruginosa equally isolated from human and cow milk were subjected to Multiplex-PCR for detection of ESBLs and exoenzymes of U, T, S, OprI, and OprL, Integrons class A encoding genes and genotyping by the ERIC-PCR and PFGE methods. The disc diffusion and E-test based on CLSI (Clinical and Laboratory Standards Institute) were performed to identify the antibiotics' resistant strains. Exotoxin A encoding gene was detected in more than 90% of the studied strains, exoenzyme S prevalence in isolated samples from animal (cow milk) was negative and the frequency of Exo Y, Exo T, and Exo U were 25%, 68.6%, and 68.6%, respectively. The frequency of VEB and GES encoding genes in human strains were detected as 3.9% and 0 by Multiplex-PCR, respectively. The highest resistance was seen to Ampicillin and Cefepime (100%) while the lowest was observed to Amikacin (80.3%). E-Test results on human and animal strains showed complete resistance to Meropenem and Ampicillin, respectively. Dendrogram of ERIC-PCR method on human isolated samples revealed 22 different groups. Frequency of Integron I encoding gene was detected as 21.5% and 1.96% in human and animal strains, respectively. In general, the present study showed the high value of genetic diversity among isolates from animal and human samples with different progenitors, but the clones classified in one cluster revealed the same source of infection.