Systemic administration of omeprazole interferes with bone healing and implant osseointegration: An in vivo study on rat tibiae

Abstract

Background Proton pump inhibitors, over-the-counter drugs taken by millions of patients, diminish bone accrual. Accordingly, we hypothesized that these drugs could impair bone healing and implant osseointegration. This study investigated the effect of post-operative systemic administration of omeprazole on bone healing and implant osseointegration in rat tibiae. Methods In 24 Sprague-Dawley rats, a titanium implant was placed in the left tibia, and a bone defect was created in the right tibia. During the 2 weeks following surgery, 12 rats were treated with omeprazole (5 mg/kg, daily) and the other 12 with saline. Then, after euthanasia, the volume (mm3) of the cortical defect and the percentages of newly formed bone in the defect, were assessed using microcomputed tomography; peri-implant bone volume/tissue volume and bone-implant contact percentage were assessed by histomorphometry. Results Omeprazole-treated rats presented larger cortical defects (2.75 ± 0.59 mm3, p = 0.003 versus 2.11 ± 0.36 mm3; p = 0.002) and a lower percentage of newly formed bone in the defects (28.62 ± 13.12; 45.89 ± 9.73; p = 0.003) than controls. Omeprazole-treated rats presented lower peri-implant bone volume/tissue volume (14.3 ± 7.3% versus 30.8 ± 11.0%; p < 0.001) and bone-implant contact (23.3 ± 10.8% versus 41.8 ± 13.3%; p < 0.001) than controls. Conclusion Systemically administered omeprazole impairs bone healing and implant osseointegration.