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Intraosseous sarcoidosis imitating peri-implantitis: A case study
Magdalena Orlowska1,2, David S Gottlieb3, Kenneth S Kornman1
1Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA.
Background:
Sarcoidosis is a multisystem granulomatous disorder of unknown cause, typically affecting the lungs and lymph nodes, but it can also involve the eyes, skin, heart, bones, and other organs. The exact cause is unclear, but genetic factors and environmental triggers like infections, chemicals, or dust may play a role. Although it may resolve on its own in some cases, sarcoidosis can cause long-term organ damage. There is no definitive cure, but many people manage the condition with minimal or no treatment, depending on the severity and organs affected.
Methods:
A 40-year-old healthy male patient was referred for a periodontal consultation with a suspected diagnosis of peri-implantitis. The patient had a generally healthy periodontium, but significant mandibular bone loss was observed around dental implants. Although bone involvement in sarcoidosis is rare, occurring in 1%-13% of patients, the patient's initial presentation was marked by alveolar bone loss, a potential first sign of intraosseous sarcoidosis.
Results:
This case reports a rare occurrence of intraosseous sarcoidosis around mandibular implants, which was initially misdiagnosed as peri-implantitis due to overlapping symptoms and radiographic features. Ultimately, the correct diagnosis was established, leading to appropriate management and a better understanding of the condition's impact on implant outcomes.
Conclusions:
Intraosseous sarcoidosis of the jaw is an uncommon condition that can mimic periodontitis or peri-implantitis due to its characteristic rapid alveolar bone loss. Dentists should be vigilant and consider sarcoidosis in differential diagnoses when encountering unexplained bone loss around implants. Early recognition and proper referral for further investigation are essential for appropriate management.
Key Points:
Intraosseous sarcoidosis can mimic periodontitis or peri-implantitis due to rapid bone loss. Dentists should consider sarcoidosis in cases of unexplained implant bone loss. Early diagnosis and referral are essential for proper management.
Plain Language Summary:
Intraosseous sarcoidosis is a rare condition where inflammation affects the bones, and it can cause symptoms similar to other dental problems like infections around implants. Because it can look like other conditions, it can be difficult to diagnose correctly. This case involves a patient who had bone loss around dental implants, initially thought to be an infection. After further investigation, the cause was found to be intraosseous sarcoidosis, a rare form of the disease affecting the jawbone. It is important for dentists to keep this condition in mind when they see unexplained bone problems around implants. Accurate diagnosis requires a thorough evaluation, often with the help of other specialists like rheumatologists, to ensure the right treatment and avoid unnecessary procedures.

