Oral Squamous Cell Carcinoma Mimicking Peri‐Implantitis

Abstract

Introduction: Peri‐implantitis is inflammation and alveolar bone loss around a dental implant. Published case reports have described squamous cell carcinoma (SCC) development around dental implants. Case Presentation: A 60‐year‐old female presented with two small fistulas on the alveolar ridge of missing tooth #18. The mucosa around the fistulas appeared normal otherwise, with no hyperplasia, erythema, or keratotic changes. The patient had a 14‐year history of recurrent erythroleukoplakia (with microscopic dysplasia) on the left tongue that had been managed by surgical removal (scalpel and carbon dioxide laser), biopsies, and close follow‐up. She had no other medical conditions. She reported that she had an implant placed to replace tooth #18 4 years ago that had been removed without flap reflection, curettage, or biopsy 1 year previously as a result of peri‐implantitis. Periapical radiographs showed that the peri‐implant radiolucency in the region of tooth #18 was unchanged in dimensions from the time of implant removal 1 year ago. Curettage and biopsy of the area were performed and showed the presence of a well‐differentiated SCC. Conclusions: This is a case of peri‐implant SCC development in a patient at high risk for oral SCC. The carcinoma was present within the alveolar defect in the area of a failed implant that had been removed 1 year previously. The overlying surface mucosa did not show the clinical changes typically seen in carcinoma. This case and others demonstrate the importance of periodic oral and radiographic examination after implant placement. Although rare, neoplasia must be considered in the evaluation of peri‐implant pathology.

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 9 cases, the authors did not describe this aspect [23,25,35,36,41,46], and only 15 patients without a history of lesions of this type …”

“…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,…”

Oral Cancer around Dental Implants: Are the Clinical Manifestations and the Oncogenic Mechanisms Unique?

“…About 3.6% of the lesions are malignant tumors (mainly squamous cell carcinomas, the most common malignancy of the oral cavity) [3]. In 2001, the first cases of malignant lesions developing around dental implants were published [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22]. Since then, the potential relationship of titanium implants with malignant tumor development has been discussed [1,5,13].…”

“…Only cases with definitive microscopic diagnosis of OSCC arising in the soft tissue around one or more dental implants were included. The literature review revealed 43 cases of patients with OSCC around dental implants in the 19 published manuscripts [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22]. All clinical and epidemiological information about the sample is summarized in the Table 1.…”

Oral Squamous Cell Carcinoma in a Patient with Vitiligo: A Case Report

“…Diagnosis of oral squamous carcinomas can be challenging for dentists due to varying clinical manifestations and can be misdiagnosed as reactive or benign lesions [16,17]. There are several published cased reports of OSCCs that mimics and misdiagnosed as denture related traumatic ulcer [17], Epstein-Barr-virus-related mucocutaneous ulceration [18] and peri-implantitis [19]. The clinical presentation of oral squamous cell carcinoma can range from a white plaque to an ulcerated lesion [20].…”