Carcinoma epidermoide oral alrededor de implantes osteointegrados: a propósito de un caso y revisión bibliográfica

Abstract

Squamous cell carcinoma surrounding osseointegrated dental implants: Clinical case and references review Introduction: Currently, dental implants is considered as the best choice for edentulism partial or complete treatment. However, this treatment has some associated medical complications such as surrounding gum squamous cell carcinoma. Even though there are not that many cases described in medical literature, it could be appropriated to determine whether there is any relation between this neoplasic disease and the dental implants. Clinical case: Presenting a 85-year-old women with PMH of lichen planus, ex-smoker and osseointegrated dental implant in areas 34, 45 and 46, with surrounding implant gum area Squamous cell carcinoma.

Cancerous lesions in the vicinity of dental implants: a systematic review

“…Practically all patients had intraoral (N = 21) [16,17,20,21,[26][27][28][29][30]32,35,36,38,39] against extraoral cancers (n = 8) [5,9,13,26,[42][43][44][45], or potentially malignant mucosal disorders (n = 29) such as leukoplakias, erythroleukoplakias or oral lichen planus lesions [6,14,18,20,[25][26][27][28]32,[36][37][38]40]. In fact, in 5 of the aforementioned cases there was a combination of previous carcinomas and potentially malignant mucosal disorders [20,27,28,32,36,38].…”

“…In addition, in 18 cases, no risk factors were identified [6,20,22,26,30,[32][33][34]36] and in 27 cases the authors did not mention whether there were any risk factors [5,6,14,16,17,24,25,27,35,36,38,[42][43][44][45][46]. Among the remaining 33 cases, the following risk factors were identified: smoking [6,21,25,26,36,37,39] (or being an ex-smoker [18,23,28,30,32,47]), alcohol consumption [6,9,21,23,[29][30][31]39,47] (or being an ex-alcohol drinker [32]), or both [6,…”

“…There were only 4 cases in which there was no history of cancer and/or potentially malignant disorders, nor risk factors [22,[32][33][34]. The most common clinical appearance was a combination of clinical signs described by most authors as periimplantitis, in the form of an exophytic lesion of the peri-implant mucosa, in some cases ulcerated, with spontaneous haemorrhage or on probing, and osteolysis [19,29,[32][33][34][35][36][37]41,46]. One author described a clinically acceptable peri-implant appearance in one patient, while radiographically, there was radiolucency along the length of the implants [44].…”

“…One author described a clinically acceptable peri-implant appearance in one patient, while radiographically, there was radiolucency along the length of the implants [44]. Some authors describe associated cervical lymphadenopathies [19,29,32,[35][36][37]41], verrucous carcinomas [32,45], paraesthesia [36,40,43] (including numb chin syndrome [44]), pain [43], lesions that did not respond to conventional treatment [5,9,[20][21][22]35,36] and of rapid evolution [13,18,23,28,32,37,42,45], bone expansion, trismus [36], purulent drainage [43] and mobility of teeth adjacent to the implant [40] or of the implants themselves [13,32]. In one case, the presence of metal filings from the implant in the affected peri-implant mucosa was described [29] and in another, the sudden appearance of cellulitis of the mental nerve area without associated bone lesions that led to the loss of osseointegration of the implant [32].…”

Dental Implants in Patients with Oral Lichen Planus: A Systematic Review

“…Even though MBL in patients with OLP is comparable to the bony resorption in healthy patients [11,17], meticulous oral hygiene and regular follow-ups are important not only to control the possibility of peri-implant mucositis and peri-implantitis, as in any patient with dental implants, but also for the early detection of malignant transformation into OSCC in the vicinity of dental implants [22]. This is very important, as peri-implantitis may closely resemble OSCC [7,10,12,16,21,22,25], with clinical signs such as gingival overgrowth, bone loss, and a tendency to bleed, although there is no epidemiologic evidence that dental implants pose any specific risk for cancer [25]. Delays in the diagnosis of peri-implantitis may pose negative consequences for the implant [51][52][53], but delayed diagnoses of malignancies may have dire implications for patient survival [25].…”