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Could I through your columns draw colleagues’ attention to the
potential risks of loss of previously successful dental implants when
patients are subsequently prescribed methotrexate. The following case is
My patient Mr S, aged 50 years, has suffered from rheumatoid
arthritis for the last 3 years, and had been treated with diclofenate. I
placed a single dental implant in August 2003 and the restoration 4 months
later. All seemed successful. In January 2004 Mr S was prescribed a 3-
month course of methorexate, and his implant failed in April 2004. An
internet search has shown other cases: “methotrexate … also can cause
dental implant failure (Brooksby)”.
My patient has accepted the situation and we have decided against
further implants, as he may need methotrexate prescribed again.
Can I suggest, as so many dental implants are now being placed, that
before methotrexate is prescribed an enquiry is made about any dental
implants and potential risks to them explained to patients.
No competing interests
07 August 2004
Christopher H Turner
Specialist in Restorative Dentistry
Cotswold Dental Specialists, 6 Park Lane, Cirencester, Glos GL7 2BS