Oral Rehabilitation with Dental Implants in Patients with Epidermolysis Bullosa: A Scoping Review

To map and synthesize the available evidence on oral rehabilitation using dental implants in edentulous patients with epidermolysis bullosa (EB), describing clinical approaches, reported outcomes in the literature, and existing gaps in knowledge.

A scoping review was conducted on March 26, 2025, following the PRISMA-ScR guidelines. Searches were made in the following databases: Cochrane Library, Embase, Google Scholar, Handbook, LILACS, PubMed/MEDLINE, SciELO, Scopus, and Web of Science. The PCC framework was applied, considering adult patients with EB (Population), oral rehabilitation with dental implants (Concept), and published clinical evidence on implant-supported rehabilitation (Context). Eligible study designs included case reports, case series, retrospective studies, prospective studies, and cohort studies. Exclusion criteria included reviews and protocols, publications not written in English, Spanish, or Portuguese, studies addressing oral mucosal lesions in a broad, and unavailable full texts. Descriptive statistics (frequencies and percentages) were used to synthesize and present the main characteristics of the included studies. Risk of bias was assessed using the appropriate JBI Critical Appraisal Checklists.

A total of 226 records were identified; after duplicate removal and screening, 16 studies met the inclusion criteria and were included in the review. All selected studies were published between 2000 and 2021. The included studies reported a total of 311 implants placed, with a low failure rate of 2.25% in patients with EB. The most frequently reported challenges in implant rehabilitation were microstomia, ankyloglossia, and vestibule obliteration. Several intraoperative precautions were recommended, such as tissue lubrication, deep and slow injection of anesthetic into the soft tissues, and the use of the minimum necessary irrigation.

Oral rehabilitation with dental implants constitutes a safe and effective therapeutic approach for individuals with epidermolysis bullosa, providing functional and nutritional benefits while minimizing oral mucosal trauma. Despite the low reported implant failure rates and high patient satisfaction, long-term clinical studies are still needed to confirm the survival of these outcomes. Comprehensive preventive and maintenance care remains essential throughout all stages of the rehabilitation process.