Peri-Implantitis and Squamous Cell Carcinoma

Peri-implantitis is a condition characterised by inflammation and loss of supporting tissue around an implant. While Peri-implantitis has produced alot of research and is not an unusual occurrence, squamous cell carcinoma developing around dental implants is seldom described or reported. What makes the carcinoma difficult to detect is that it initially mimics peri-implantitis. A recent study ¹, presented the case of a 62-year-old who had a dental implant, which was thought to have developed peri-implantitis, but was subsequently biopsied, and confirmed to be a squamous cell carcinoma.

The authors conclude that:

Although rare, the possibility of peri-implant squamous cell carcinoma should be borne in mind by all practitioners who monitor implant patients.
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Another study, ² conducted back in 2009, reported on a patient who suffered from multiple episodes of peri-implantitis and later on went on to develop oral squamous cell carcinoma around two of the dental implants.
The authors conclude that:

It must be remembered that the cause of oral cancer is multifactorial and includes tobacco use, alcohol consumption, human papilloma virus, UV light exposure and dietary factors amongst others…Peri-implantitis is a wellrecognised condition. Any patient who has had an oral squamous cell carcinoma is considered at risk of a recurrence. In cases such as this, it is important to gain histological diagnosis of any areas of implantitis, especially those which are not responding to local therapeutic measures.
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Do you take any extra precautions in your practice when encountering peri-implantitis to ensure it is only peri-implantitis? Do you think more biopsies are appropriate in certain circumstances, considering the risks?

1.Peri-implant squamous cell carcinoma .Aust Dent J. 2018 Jun;63(2):261-264. Ito K et. al.

2.Squamous Cell Carcinoma Presenting as Peri-Implantitis: A Case Report. Ann R Coll Surg Engl. 2009 Oct;. Aakshay Gulati et al.