The Importance of Histopathological Diagnosis in the Management of Lesions Presenting as Peri‐Implantitis

Kaplan, Ilana; Hirshberg, Avraham; Shlomi, Benjamin; Platner, Ori; Ofec, Ronen; Schwartz‐Arad, Devorah

doi:10.1111/cid.12137

Cited by 15 publications

(24 citation statements)

References 25 publications

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“…All of the cases in the present review had an exophytic appearance similar to classic cases of PGCG and PG, but Kaplan et al. reported that some reactive lesions might present as peri‐implantitis without nodular tissue formation . One implant was not osseointegrated, whereas all the others were associated with no mobility.…”

Section: Discussionmentioning

confidence: 52%

Reactive oral lesions associated with dental implants. A systematic review

Atarbashi-Moghadam

Namdari

et al. 2018

J of Invest & Clin Dent

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Reactive lesion formation around dental implants a complication that has been given much consideration. These lesions can lead to marginal bone loss, and consequently, implant failure. In the present systematic review, all reported reactive lesions associated with dental implants in the literature were assessed. An electronic search was performed using PubMed Central, Scopus, Google Scholar, and Science Direct. The search strategy was limited to human studies (case reports and case series), full-text English language articles, published until May 2017. A total of 19 articles reporting 27 lesions in 25 cases were included. Peripheral giant cell granuloma and pyogenic granuloma were the most reactive lesions found around dental implants. The mean age of the patients was 51.28 ± 14.48 years, with a slight female predilection. Posterior mandibular gingiva was the most common location for these lesions. The recurrence rate of lesions was 33.33%, and the chance of implant removal was 29.62%. Due to the clinical significance of these lesions, early histopathologic examination is recommended to exclude the presence of such pathological lesions. K E Y W O R D Sdental implant, foreign bodies, peripheral giant cell granuloma, pyogenic granuloma, reactive oral lesion

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Section: Discussionmentioning

confidence: 52%

Reactive oral lesions associated with dental implants. A systematic review

Atarbashi-Moghadam

Namdari

et al. 2018

J of Invest & Clin Dent

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“…Such lesions include primary malignant tumors (i.e. oral squamous cell carcinoma) or metastases as well as giant cell and pyogenic granuloma …”

Section: Observations and Discussionmentioning

confidence: 99%

“…While these pathologic conditions share several clinical features with peri‐implant diseases, they reveal distinct differences to a nonspecific inflammation at the histopathologic level …”

Section: Observations and Discussionmentioning

confidence: 99%

“…oral squamous cell carcinoma) [73][74][75][76] or metastases 77 as well as giant cell and pyogenic granuloma. [78][79][80][81][82][83][84][85][86] While these pathologic conditions share several clinical features with peri-implant diseases, they reveal distinct differences to a nonspecific inflammation at the histopathologic level. 86…”

Section: Periapical Peri-implantitismentioning

confidence: 99%

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Peri‐implantitis

Schwarz

Derks

Monje

et al. 2018

J Clinic Periodontology

603

585

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1)Peri-implantitis is a pathological condition occurring in tissues around dental implants, characterized by inflammation in the peri-implant connective tissue and progressive loss of supporting bone. 2)The histopathologic and clinical conditions leading to the conversion from peri-implant mucositis to peri-implantitis are not completely understood. 3)The onset of peri-implantitis may occur early during follow-up and the disease progresses in a non-linear and accelerating pattern. 4a)Peri-implantitis sites exhibit clinical signs of inflammation and increased probing depths compared to baseline measurements. 4b)At the histologic level, compared to periodontitis sites, peri-implantitis sites often have larger inflammatory lesions. 4c)Surgical entry at peri-implantitis sites often reveals a circumferential pattern of bone loss. 5a)There is strong evidence that there is an increased risk of developing peri-implantitis in patients who have a history of chronic periodontitis, poor plaque control skills, and no regular maintenance care after implant therapy. Data identifying "smoking" and "diabetes" as potential risk factors/indicators for peri-implantitis are inconclusive. 5b)There is some limited evidence linking peri-implantitis to other factors such as: post-restorative presence of submucosal cement, lack of peri-implant keratinized mucosa and positioning of implants that make it difficult to perform oral hygiene and maintenance. 6)Evidence suggests that progressive crestal bone loss around implants in the absence of clinical signs of soft tissue inflammation is a rare event.

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“…Dental implants are safe procedures for restoring tooth loss, but their failure can be influenced by different local and systemic factors. Local benign and malignant conditions are rarely reported in association with dental implants (Kaplan et al, ; Kaplan et al, ), and implant‐associated peripheral giant cell granuloma (IA‐PGCG) is one of the most relevant peri‐implant hyperplastic lesions reported (Olmedo, Paparella, Brandizzi, & Cabrini, ). This lesion is a reactive condition that occurs in the gingival or alveolar mucosa, and it is characterized by an unencapsulated proliferation of mononuclear ovoid or spindle‐shaped cells intermingled with osteoclast‐type multinucleated cells in a vascular background.…”

Section: Introductionmentioning

confidence: 99%

KRAS mutations in implant‐associated peripheral giant cell granuloma

et al. 2019

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Objectives To investigate the molecular pathogenesis of implant‐associated peripheral giant cell granuloma (IA‐PGCG). Methods A convenience sample of 15 IA‐PGCG cases was selected. Hotspot mutations of KRAS, FGFR1, and TRPV4 genes, previously reported in conventional giant cell lesions of the jaws, were investigated by Sanger sequencing. As these mutations could activate MAPK/ERK pathway, the expression of phospho‐ERK1/2 was also evaluated by immunohistochemistry. Results KRAS mutations were detected in 8/15 (53.4%) samples. Similar to conventional peripheral giant cell granuloma, the KRAS mutations most frequently occurred in codon 146 (p.A146V, n = 3), followed by codon 12 (p.G12A and p.G12D, n = 1 each) and codon 14 (p.V14L, n = 1). Variants of unknown significance (VUS) were also detected in two cases, affecting codons 37 (p.E37K) and 127 (p.T127I). All samples showed wild‐type (WT) sequences for FGFR1 and TRPV4 genes. Consistent with MAPK/ERK pathway activation, all mononuclear cells of the lesion showed strong staining for phospho‐ERK1/2 protein in the immunohistochemical analysis. Conclusions KRAS mutations and activation of the MAPK‐ERK signaling pathway occur in IA‐PGCG. This is the first study to demonstrate cancer‐associated gene mutations in a non‐neoplastic reactive condition associated with dental implants.

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The Importance of Histopathological Diagnosis in the Management of Lesions Presenting as Peri‐Implantitis

Cited by 15 publications

References 25 publications

Reactive oral lesions associated with dental implants. A systematic review

Reactive oral lesions associated with dental implants. A systematic review

Peri‐implantitis

KRAS mutations in implant‐associated peripheral giant cell granuloma

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