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Primary Oral Malignancy Imitating Peri-Implantitis.

Vadim Raiser1, Immad Abu-El Naaj2, Benjamin Shlomi3

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Journal of Oral and Maxillofacial Surgery : Official Journal of the American Association of Oral and Maxillofacial Surgeons
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PubMed
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Malignancies like squamous cell carcinoma can arise around dental implants, mimicking peri-implantitis. Early diagnosis through histopathology is crucial, especially in patients with oral cancer risk factors.

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Area of Science:

  • Oral pathology
  • Dental implantology
  • Oncology

Background:

  • Peri-implantitis is a common complication of dental implants.
  • Malignancies in the peri-implant mucosa can present with similar symptoms.
  • Early detection of peri-implant lesions is critical for patient outcomes.

Observation:

  • Three new cases of primary peri-implant malignancy are presented: one large B-cell lymphoma and two squamous cell carcinomas in patients with oral lichen planus.
  • A literature review identified 42 implant-associated malignancies between 2000-2014, predominantly squamous cell carcinoma.

Findings:

  • Squamous cell carcinoma accounted for 85.7% of implant-associated malignancies, with most patients having pre-existing oral cancer risk factors.
  • Lymphoma was not found to be associated with dental implants in the reviewed literature.
  • Malignancies can present asymptomatically with clinical and radiographic features similar to peri-implantitis.

Implications:

  • Clinicians must maintain a high index of suspicion for peri-implant mucosal changes, especially in patients with risk factors for oral cancer.
  • While rare, conditions like lymphoma may occur in patients without typical risk factors.
  • Histopathologic examination of suspicious peri-implant lesions is essential to prevent delayed diagnosis of malignancy.