Clinical Management Protocol for Dental Implants Inserted in Patients with Active Lichen Planus. Part II 4‐Year Follow‐Up

Abstract

Purpose: To evaluate marginal bone loss (MBL) of dental implants inserted in active lichen planus patients. Materials and Methods:The study included 59 subjects divided into 3 groups depending on their lichen planus diagnosis and administration of a low dose of corticosteroids: 17 healthy individuals, 20 controlled lichen planus patients controlled using low doses of systemic corticosteroids, and 22 noncontrolled lichen planus patients. During 4-year follow-up sessions MBL was evaluated, and biopsies were collected from lichen planus patients and examined. Two-way ANOVA was used to analyze the data (α = 0.05).

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

“…This low rate occurred after not considering the data from a study that presented an implant failure rate of 76.4% [6], and also by excluding the cases of patients that developed OSCC. The disagreements of the results of this [6] and another study of the same group [19] with many other results from the literature (see the following paragraphs) could be a matter of chance, but the presence of so many incongruences, confusing reports, and some conflicting data makes one think over these results. Is the simple manifestation of OLP strong enough to overcome all other confounding factors and play such a powerful negative influence on osseointegration?…”

“…This goes against the results of several publications that observed that dental implants replacing failed implants had much lower survival rates than the rates reported for the previous attempts of implant placement [34][35][36][37][38]. Despite the condition having an established prevalence in females, Aboushelib et al [6] and Khamis et al [19] reported that nearly half of their patients were males. Furthermore, the authors of the first study failed to include two important controls: a healthy control versus the OLP study group, and after the implant removal a protocol healing group (corticosteroids and laser) versus a natural healing control group.…”

“…Such extremely high implant failure rate observed by Aboushelib et al [6] is not expected even in patients irradiated in the head and neck region [32] or for implants placed in sites with the worst bone quality [33]. Despite quoting the first study twice, the second publication [19] made no comment or discussion about the alarming results found in the first one [6]. It was stated that the 23 patients of the study were "suffering from active lichen planus", but it was not informed whether or not the patients were under some therapy for OLP, being corticosteroid or any other.…”

“…If the results of all studies included in the present review are taken into consideration, one can say that the answer is not entirely clear yet. However, since the results of these two studies [6,19] just do not add up, one may suggest that the implant failure rate in patients with OLP is fairly low. Therefore, it is important to make some comments and explain the reasons why the results of Aboushelib et al [6] were not considered here.…”

“…Second, in order for this to happen, the lesion would have to be affecting the surgical site of all implants. This information was, however, not available neither from the first study [6] nor from the second [19]. And further to this important last point, the reason for implant failure is assumed to be from a soft tissue failure; however, osseointegration is a process of the bone as a tissue.…”