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Keane Tahmaseb GC, Keane AM, Foppiani JA, Myckatyn TM. An Update on Implant-Associated Malignancies and Their Biocompatibility. Int J Mol Sci 2024; 25:4653. [PMID: 38731871 PMCID: PMC11083590 DOI: 10.3390/ijms25094653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Revised: 04/14/2024] [Accepted: 04/22/2024] [Indexed: 05/13/2024] Open
Abstract
Implanted medical devices are widely used across various medical specialties for numerous applications, ranging from cardiovascular supports to orthopedic prostheses and cosmetic enhancements. However, recent observations have raised concerns about the potential of these implants to induce malignancies in the tissues surrounding them. There have been several case reports documenting the occurrence of cancers adjacent to these devices, prompting a closer examination of their safety. This review delves into the epidemiology, clinical presentations, pathological findings, and hypothesized mechanisms of carcinogenesis related to implanted devices. It also explores how the surgical domain and the intrinsic properties and biocompatibility of the implants might influence the development of these rare but serious malignancies. Understanding these associations is crucial for assessing the risks associated with the use of medical implants, and for developing strategies to mitigate potential adverse outcomes.
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Affiliation(s)
- Grace C. Keane Tahmaseb
- Division of Plastic and Reconstructive Surgery, Washington University School of Medicine, St. Louis, MO 63130, USA; (G.C.K.T.); (A.M.K.)
| | - Alexandra M. Keane
- Division of Plastic and Reconstructive Surgery, Washington University School of Medicine, St. Louis, MO 63130, USA; (G.C.K.T.); (A.M.K.)
| | - Jose A. Foppiani
- Division of Plastic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA;
| | - Terence M. Myckatyn
- Division of Plastic and Reconstructive Surgery, Washington University School of Medicine, St. Louis, MO 63130, USA; (G.C.K.T.); (A.M.K.)
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Alresayes S, Mokeem SA, Alhenaki AM, Vohra F, Abduljabbar T. Evaluation of the implant diameter on the initial-stability of narrow- and standard-diameter implants placed in simulated Type-I and Type-IV bone-blocks. Pak J Med Sci 2021; 37:812-815. [PMID: 34104170 PMCID: PMC8155436 DOI: 10.12669/pjms.37.3.3943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Objective: A comparison of the initial stability of narrow- and standard-diameter implants (SDIs) placed in Type-I and Type-IV bone-blocks is not yet reported. The aim was to evaluate in-vitro the influence of implant diameter on the initial stability of narrow- and standard-diameter implants (SDIs) placed in simulated Type-I and Type-IV bone-blocks. Methods: The present experimental in-vitro study was performed between July and September 2020 at the Specialist Dental Practice, Riyadh, Saudi Arabia. Narrow- and standard-diameter implants were placed 3-mm apart in simulated soft (Type-IV) and dense (Type-I) bone blocks by a trained and calibrated investigator. In groups A (Type-IV bone blocks) and B (Type-I bone blocks), implants were inserted using an insertion-torque and drilling-speed of 15-30 Ncm and 1000-1500 rpm, respectively with the implant collar at the crest of simulated bone blocks. In all samples, initial-stability was recorded using resonance frequency analysis (RFA). Sample-size estimation was done and group-comparisons were carried out. A P-value of 0.01 or less reflected statistical significance. Results: In Groups-A and -B, 44 (22 NDIs and 22 SDIs) and 44 (22 NDIs and 22 SDIs) were placed. In group-A, the mean RFA values for NDIs and SDIs were 68.5 ± 3.5 and 69.1 ± 2.4, respectively. In Group-B, the mean RFA values for NDIs and SDIs were 78.06 ± 9.6 and 75.3 ± 5.2. RFA values among NDIs and SDIs in groups A and B were similar. Conclusion: The NDIs and SDIs show comparable initial-stability when positioned in simulated Type-I and Type-IV bone blocks.
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Affiliation(s)
- Saad Alresayes
- Saad Alresayes, BDS Department of Prosthetic Dental Science, College of Dentistry, King Saud University, Riyadh 11545, Saudi Arabia
| | - Sameer A Mokeem
- Sameer A. Mokeem, BDS, MSc Department of Periodontics and Community Dentistry, King Saud University, Riyadh 11545, Saudi Arabia
| | - Aasem M Alhenaki
- Aasem M Alhenaki, BDS, MSc Department of Prosthetic Dental Science, College of Dentistry, King Saud University, Riyadh 11545, Saudi Arabia
| | - Fahim Vohra
- Fahim Vohra, MRD, PhD Department of Prosthetic Dental Science, College of Dentistry and Research Chair for Biological Research in Dental Health, College of Dentistry, Riyadh 11545, Saudi Arabia
| | - Tariq Abduljabbar
- Tariq Abduljabbar, BDS, DMSc Department of Prosthetic Dental Science, College of Dentistry and Research Chair for Biological Research in Dental Health, College of Dentistry, Riyadh 11545, Saudi Arabia
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Ramos JC, Dos Santos ES, Normando AGC, Alves FA, Kowalski LP, Santos-Silva AR, Vargas PA, Lopes MA. Oral squamous cell carcinoma around dental implants: a systematic review. Oral Surg Oral Med Oral Pathol Oral Radiol 2021; 131:660-674. [PMID: 33653646 DOI: 10.1016/j.oooo.2021.01.019] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 12/21/2020] [Accepted: 01/21/2021] [Indexed: 01/04/2023]
Abstract
OBJECTIVE This systematic review aimed to evaluate the epidemiologic profile, screen for possible risk factors, and evaluate the spectrum of clinical characteristics of oral squamous cell carcinoma (OSCC) around dental implants (DIs). METHODS The systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta- Analyses statement. RESULTS Thirty-three articles met the eligibility criteria. In total, the sample consisted of 63 patients, and women comprised the majority (55.5%). The mean age of patients was 66.7 years. Oral potentially malignant disorders were reported in 46% of patients, of which 65.5% occurred in women. The most common lesion found in women was oral lichen planus (52.6%). In 88.8% of patients OSCC around DIs occurred in the mandible, and the most common clinical appearance of the lesions was an exophytic mass (46%). Most of these lesions were initially treated as peri-implantitis. CONCLUSIONS Most patients with OSCC around DIs were women without known risk factors. It is important to emphasize that these lesions may present clinical and radiographic features that could resemble peri-implantitis, which can lead to delay in the diagnosis and subsequent treatment.
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Affiliation(s)
- Joab Cabral Ramos
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | | | | | - Fábio Abreu Alves
- Department of Stomatology, A.C. Camargo Cancer Center, São Paulo, Brazil
| | - Luiz Paulo Kowalski
- Department of Head and Neck Surgery and Otorhinolaryngology, A.C. Camargo Cancer Center, and Head and Neck Surgery Department, University of Sao Paulo Medical School, São Paulo, Brazil
| | - Alan Roger Santos-Silva
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | - Pablo Agustin Vargas
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | - Marcio Ajudarte Lopes
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil.
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Quach H, Ray-Chaudhuri A. Calcium channel blocker induced gingival enlargement following implant placement in a fibula free flap reconstruction of the mandible: a case report. Int J Implant Dent 2020; 6:47. [PMID: 32808200 PMCID: PMC7431483 DOI: 10.1186/s40729-020-00242-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Accepted: 06/30/2020] [Indexed: 11/10/2022] Open
Abstract
Background Gingival tissue enlargement is a common side effect of antiepileptic medications (e.g. phenytoin and sodium valproate), immunosuppressing drugs (e.g. cyclosporine) and calcium channel blockers (e.g. nifedipine, verapamil, amlodipine) (Murakami et al. 2018, Clin Periodontol 45:S17–S27, 2018). The clinical and histological appearances of lesions caused by these drugs are indistinguishable from one another (Murakami et al. 2018, Clin Periodontol 45:S17–S27, 2018). Drug-induced gingival enlargement is rarely seen in edentulous patients. Case presentation This case presents a 72-year-old female with a history of squamous cell carcinoma of the floor of the mouth treated with surgical excision and fibula-free flap reconstruction. Following the uncovering of osseointegrated implants placed in the fibular-free flap, the patient developed gingival enlargement of the floor of the mouth. Cessation of amlodipine and switching to an alternative medication lead to a resolution of the enlarged tissue. Conclusions This case illustrates that gingival enlargement can occur around dental implants, most notably in rehabilitation cases in patients who have had head and neck cancer. Clinicians should be aware of the risk of gingival enlargement in hypertensive patients taking calcium channel blockers prior to implant placement.
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Affiliation(s)
- Henry Quach
- Department of Restorative Dentistry, Royal Sussex County Hospital, Brighton, UK.
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Oral squamous cell carcinoma around dental implant mimicking peri-implantitis. Oral Oncol 2020; 105:104759. [PMID: 32386923 DOI: 10.1016/j.oraloncology.2020.104759] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 04/28/2020] [Indexed: 11/23/2022]
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Kaplan I, Zeevi I, Tal H, Rosenfeld E, Chaushu G. Clinicopathologic evaluation of malignancy adjacent to dental implants. Oral Surg Oral Med Oral Pathol Oral Radiol 2017; 123:103-112. [DOI: 10.1016/j.oooo.2016.08.023] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2016] [Revised: 08/07/2016] [Accepted: 08/22/2016] [Indexed: 11/28/2022]
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Salgado-Peralvo AO, Arriba-Fuente L, Mateos-Moreno MV, Salgado-García A. Is there an association between dental implants and squamous cell carcinoma? Br Dent J 2016; 221:645-649. [DOI: 10.1038/sj.bdj.2016.863] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/29/2016] [Indexed: 12/13/2022]
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Raiser V, Abu-El Naaj I, Shlomi B, Fliss DM, Kaplan I. Primary Oral Malignancy Imitating Peri-Implantitis. J Oral Maxillofac Surg 2016; 74:1383-90. [DOI: 10.1016/j.joms.2016.02.008] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2016] [Revised: 02/11/2016] [Accepted: 02/11/2016] [Indexed: 10/22/2022]
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Nariai Y, Kanno T, Sekine J. Histopathological Features of Secondary Squamous Cell Carcinoma Around a Dental Implant in the Mandible After Chemoradiotherapy: A Case Report With a Clinicopathological Review. J Oral Maxillofac Surg 2016; 74:982-90. [DOI: 10.1016/j.joms.2015.11.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2015] [Revised: 11/04/2015] [Accepted: 11/04/2015] [Indexed: 10/22/2022]
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Chainani-Wu N, Chang C, Sim C, Wu TC, Cox D, Sirjani D, Silverman S. Oral Squamous Cell Carcinoma Mimicking Peri-Implantitis. Clin Adv Periodontics 2016; 6:83-88. [DOI: 10.1902/cap.2015.150041] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2015] [Accepted: 09/01/2015] [Indexed: 12/11/2022]
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Kaplan I, Hirshberg A, Shlomi B, Platner O, Kozlovsky A, Ofec R, Schwartz-Arad D. The Importance of Histopathological Diagnosis in the Management of Lesions Presenting as Peri-Implantitis. Clin Implant Dent Relat Res 2013; 17 Suppl 1:e126-33. [DOI: 10.1111/cid.12137] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Ilana Kaplan
- Tel-Aviv Sourasky Medical Center; Tel-Aviv
- Department of Pathology; Sackler School of Medicine; Tel-Aviv University; Ramat-Aviv Israel
| | - Avraham Hirshberg
- Department of Oral Pathology and Oral Medicine; The Maurice and Gabriela Goldschleger School of Dental Medicine; Tel Aviv University; Tel Aviv Israel
| | - Benjamin Shlomi
- Tel-Aviv Sourasky Medical Center; Tel-Aviv and Goldschleger School of Dental Medicine; Tel Aviv University; Tel Aviv Israel
| | - Ori Platner
- Department of Periodontology; Goldschleger School of Dental Medicine; Tel-Aviv University; Ramat-Aviv Israel
| | - Avital Kozlovsky
- Department of Periodontology; Goldschleger School of Dental Medicine; Tel-Aviv University; Ramat-Aviv Israel
| | - Ronen Ofec
- private dental practice and Biostatistics; Tel-Aviv Israel
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Javed F, Alghamdi AST, Ahmed A, Mikami T, Ahmed HB, Tenenbaum HC. Clinical efficacy of antibiotics in the treatment of peri-implantitis. Int Dent J 2013; 63:169-76. [PMID: 23879251 DOI: 10.1111/idj.12034] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVES The aim of the present study was to review the pertinent literature with reference to the clinical efficacy of antibiotics in the treatment of peri-implantitis. METHODS To address the focused question 'Are locally and systemically delivered antibiotics useful in the treatment of peri-implantitis?' PubMed/Medline and Google-scholar databases were explored from 1992 until February 2013 using a combination of the following keywords: 'antibiotic,' 'dental implant,' 'inflammation,', 'peri-implantitis' and 'treatment'. Letters to the editor, case-reports and unpublished data were excluded. RESULTS Ten studies were included. In six studies, peri-implantitis was treated using a non-surgical approach (scaling and root planing), whereas in four studies, a surgical approach was adopted for treating peri-implantitis. In three studies systemic antibiotics were administered and in six studies locally delivered antibiotics were used for treatment. One study used the oral route for antibiotic delivery. In three studies, minocycline hydrochloride was locally delivered as an adjunctive therapy to non-surgical mechanical debridement of infected sites. Nine studies reported that traditional peri-implantitis treatment with adjunct antibiotic therapy reduces gingival bleeding, suppuration and peri-implant pocket depth. In one study, despite surgical debridement of infected sites and systemic antibiotic cover, nearly 40% of the implants failed to regain stability. There was no placebo or control group in eight out of the nine studies included. CONCLUSION The significance of adjunctive antibiotic therapy in the treatment of peri-implantitis remains debatable.
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Affiliation(s)
- Fawad Javed
- College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia.
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