Vadim Raiser1, Immad Abu-El Naaj2, Benjamin Shlomi3, Dan M Fliss4, Ilana Kaplan5. 1. Senior Surgeon, Oral and Maxillofacial Surgery Unit, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel. 2. Department Head, Department of Oral and Maxillofacial Surgery, The Baruch Padeh Medical Center, Poriya, Israel. 3. Department Head, Unit of Oral and Maxillofacial Surgery, Tel-Aviv Sourasky Medical Center; Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel. 4. Professor and Division Head, Division of Otolaryngology and Head and Neck Surgery, Tel-Aviv Sourasky Medical Center; Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel. 5. Professor, Institute of Pathology, Tel-Aviv Sourasky Medical Center, Tel-Aviv; Goldschleger School of Dental Medicine; Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel. Electronic address: Dr.ilanakaplan@gmail.com.
Abstract
PURPOSE: To describe new cases of primary malignancy arising around dental implants. MATERIALS AND METHODS: Three patients presented with asymptomatic lesions around longstanding dental implants that resembled peri-implantitis. One case was primary large B-cell lymphoma and the remaining cases were primary squamous cell carcinoma in patients with oral lichen planus. The literature was reviewed for cases mimicking peri-implantitis. RESULTS: Of 42 implant-associated malignancies reported from 2000 through 2014, 85.7% were squamous cell carcinoma (69% primary and 9.4% metastatic). Most patients presented with pre-existing risk factors for oral cancer. Lymphoma was not associated with dental implants. CONCLUSIONS: Primary and metastatic malignancies can occur in peri-implant mucosa, often with clinical and radiographic features resembling peri-implantitis. Clinicians should have a high index of suspicion for changes in peri-implant mucosa in patients with existing risk factors; however, rare cases such as lymphoma might present outside this risk population. Histopathologic analysis should be included in the management of selected peri-implant lesions to avoid delayed diagnosis of malignancy.
PURPOSE: To describe new cases of primary malignancy arising around dental implants. MATERIALS AND METHODS: Three patients presented with asymptomatic lesions around longstanding dental implants that resembled peri-implantitis. One case was primary large B-cell lymphoma and the remaining cases were primary squamous cell carcinoma in patients with oral lichen planus. The literature was reviewed for cases mimicking peri-implantitis. RESULTS: Of 42 implant-associated malignancies reported from 2000 through 2014, 85.7% were squamous cell carcinoma (69% primary and 9.4% metastatic). Most patients presented with pre-existing risk factors for oral cancer. Lymphoma was not associated with dental implants. CONCLUSIONS: Primary and metastatic malignancies can occur in peri-implant mucosa, often with clinical and radiographic features resembling peri-implantitis. Clinicians should have a high index of suspicion for changes in peri-implant mucosa in patients with existing risk factors; however, rare cases such as lymphoma might present outside this risk population. Histopathologic analysis should be included in the management of selected peri-implant lesions to avoid delayed diagnosis of malignancy.