Association Between Proton Pump Inhibitor Use and the Severity of Periodontal Disease and Peri-Implantitis: A Systematic Review

This systematic review investigates the probable effect of proton pump inhibitor (PPI) use on the severity of periodontal disease and peri-implantitis and implant survival. We conducted a literature search in PubMed, Scopus, and Cochrane Central Library up to April 2024. Two review authors independently screened the title and abstracts and then the full texts of retrieved studies. Observational and clinical trial studies that assessed the association between PPI use and periodontal disease severity and peri-implantitis or implant survival were included. Data extraction from the included studies was done by 2 reviewers independently. Of 940 studies initially retrieved from online searching, 7 met the inclusion criteria. Three studies examined periodontitis, whereas 4 focused on peri-implantitis and implant longevity. On the contrary, evidence regarding the impact of PPI use on peri-implantitis and implant survival is conflicting. Therefore, more well-designed randomized controlled trials are warranted to come to a definite conclusion. Because PPIs alter the gut microbiome and affect bone, plus that the pathogenesis and etiology of periodontal disease are affected by bacteria within the periodontal pocket, it is hypothesized that they may affect periodontal pathogenesis.