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Li JW, Kot WY, McGrath CP, Chan BWA, Zheng LW. Stabilized oral lichen planus does not compromise dental implants survival: A systematic review and meta-analysis. Oral Dis 2024; 30:3850-3865. [PMID: 38735757 DOI: 10.1111/odi.14964] [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: 01/03/2024] [Revised: 03/12/2024] [Accepted: 04/07/2024] [Indexed: 05/14/2024]
Abstract
BACKGROUND This study aimed to evaluate the incidence of implant failure in patients with oral lichen planus (OLP) and investigate the potential association between OLP and peri-implant diseases. MATERIALS AND METHODS Embase, Web of Science, PubMed, and Scopus databases were searched for studies with no time restrictions. Meta-analysis was performed calculating pooled proportion of peri-implantitis (PI), peri-implant mucositis (PIM), and bleeding on probing (BOP) prevalence using fixed-effects model. Odds ratio and corresponding 95% CI were calculated to assess the potential risk of PI, PIM, and BOP in dental implant patients with OLP compared to healthy controls. RESULTS Implant failure rate was 4.38% at the patient level and 4.37% at the implant level. Six patients (3.92%) from five studies were diagnosed with oral cancer after receiving implant. The prevalence of PI, PIM, and BOP at the implant level were 14.00%, 20.00%, and 40.00%, respectively. There was no significant difference in the occurrence of PI and PIM between OLP patients and healthy controls. CONCLUSIONS Stabilized OLP is not considered a significant risk factor for peri-implant diseases. It is advised against placing implants or prostheses during the acute phase of the disease. Histopathological investigation to differentiate OLP from oral lichenoid dysplasia is crucial.
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Affiliation(s)
- Jing Wen Li
- Division of Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Wai Ying Kot
- Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Colman Patrick McGrath
- Division of Applied Oral Sciences & Community Dental Care, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Bik Wan Amy Chan
- Department of Anatomical and Cellular Pathology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Li Wu Zheng
- Division of Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
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Sarafidou K, Lekatsa M, Michou A, Bakopoulou A, Poulopoulos A, Andreadis D. Implant Treatment in Patients With Autoimmune Diseases: A Systematic Review and Analysis of Studies. Cureus 2024; 16:e67617. [PMID: 39310633 PMCID: PMC11416833 DOI: 10.7759/cureus.67617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/18/2024] [Indexed: 09/25/2024] Open
Abstract
Dental implants provide a reliable solution for edentulous patients with autoimmune diseases improving quality of life. The present systematic review aimed to determine whether autoimmune diseases with oral manifestations could affect the survival rate of dental implants. A systematic search was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (PRISMA), using Google Scholar and PubMed electronic databases, between the year 2000 and February 2024. The eligibility criteria included human studies, in English language reporting on patients with autoimmune diseases treated with dental implants. Nineteen studies were included: nine on oral lichen planus (OLP), four on Sjögren's syndrome (SS), five on epidermolysis bullosa (EB), and one on lupus erythematosus (LE). A total of 389 implants in 142 patients with OLP showed a survival rate (SR) of 94.6%, while 316 implants in 111 patients with SS had a survival rate of 95.8%. In 31 patients with EB, 181 implants were placed with a survival rate of 99.5%, and 12 implants were placed in five patients with LE with a survival rate of 100% after one year of function. Despite the heterogeneity and methodological limitations of most of the studies, the results showed that dental implant survival rates were comparable to those reported in the general population. This review suggested that dental implants are a viable treatment option for patients with autoimmune diseases. Nevertheless, proper daily oral hygiene and long-term follow-up are decisive factors for the long-term maintenance of dental implants.
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Affiliation(s)
- Katia Sarafidou
- Prosthodontics, School of Dentistry, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, GRC
| | - Maria Lekatsa
- Dental Surgery, School of Dentistry, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, GRC
| | - Amalia Michou
- Dental Surgery, School of Dentistry, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, GRC
| | - Athina Bakopoulou
- Prosthodontics, School of Dentistry, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, GRC
| | - Athanasios Poulopoulos
- Oral Medicine/Pathology, School of Dentistry, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, GRC
| | - Dimitrios Andreadis
- Oral Medicine/Pathology, School of Dentistry, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, GRC
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Hyldahl E, Gotfredsen K, Lynge Pedersen AM, Storgård Jensen S. Survival and Success of Dental Implants in Patients with Autoimmune Diseases: a Systematic Review. J Oral Maxillofac Res 2024; 15:e1. [PMID: 38812949 PMCID: PMC11131373 DOI: 10.5037/jomr.2024.15101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Accepted: 03/31/2024] [Indexed: 05/31/2024]
Abstract
Objectives The purpose of this systematic review is to disclose the impact of autoimmune diseases and their medical treatment on dental implant survival and success. Material and Methods A literature search was conducted using MEDLINE (PubMed), The Cochrane Library and Embase up to December 6th, 2021. Any clinical study on patients with an autoimmune disease in whom implant therapy was performed was eligible. The quality of included studies was assessed using the Newcastle-Ottawa Scale. For each autoimmune disease group, data synthesis was divided into three groups: 1) overall results of the autoimmune disease, 2) overall results of corresponding control groups and 3) overall results of the autoimmune disease with a concomitant autoimmune disease (a subgroup of group 1). Descriptive statistics were used. Results Of 4,865 identified articles, 67 could be included and mainly comprising case reports and retrospective studies with an overall low quality. Implant survival rate was 50 to 100% on patient and implant level after a weighted mean follow-up of 17.7 to 68.1 months. Implant success was sporadically reported. Data on immunosuppressive medication were too heterogeneously reported to allow detailed analysis. Conclusions Overall, a high implant survival rate was reported in patients with autoimmune diseases. However, the identified studies were characterized by a low quality. No conclusions could be made regarding implant success and the effect of immunosuppressants due to heterogeneous reporting.
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Affiliation(s)
- Emil Hyldahl
- Oral Surgery, Section for Oral Biology and Immunopathology, Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, CopenhagenDenmark.
| | - Klaus Gotfredsen
- Oral Rehabilitation, Section for Oral Health, Society and Technology, Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, CopenhagenDenmark.
| | - Anne Marie Lynge Pedersen
- Oral Pathology and Medicine, Section for Oral Biology and Immunopathology, Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, CopenhagenDenmark.
| | - Simon Storgård Jensen
- Oral Surgery, Section for Oral Biology and Immunopathology, Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, CopenhagenDenmark.
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Khamis A, Salzer L, Schiegnitz E, Stauber RH, Gül D. The Magic Triangle in Oral Potentially Malignant Disorders: Vitamin D, Vitamin D Receptor, and Malignancy. Int J Mol Sci 2023; 24:15058. [PMID: 37894739 PMCID: PMC10606220 DOI: 10.3390/ijms242015058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 09/27/2023] [Accepted: 09/28/2023] [Indexed: 10/29/2023] Open
Abstract
OPMDs (oral potentially malignant disorders) are a group of disorders affecting the oral mucosa that are characterized by aberrant cell proliferation and a higher risk of malignant transformation. Vitamin D (VitD) and its receptor (VDR) have been extensively studied for their potential contributions to the prevention and therapeutic management of various diseases and neoplastic conditions, including oral cancer. Observational studies suggest correlations between VitD deficiency and higher cancer risk, worse prognosis, and increased mortality rates. Interestingly, emerging data also suggest a link between VitD insufficiency and the onset or progression of OPMDs. Understanding the role of the VitD-VDR axis not only in established oral tumors but also in OPMDs might thus enable early detection and prevention of malignant transformation. With this article, we want to provide an overview of current knowledge about OPMDs and VitD and investigate their potential association and ramifications for clinical management of OPMDs.
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Affiliation(s)
- Aya Khamis
- Department of Otorhinolaryngology Head and Neck Surgery, Molecular and Cellular Oncology, University Medical Center, 55131 Mainz, Germany; (L.S.); (R.H.S.)
- Department of Oral and Maxillofacial Surgery, Plastic Surgery, University Medical Center of the Johannes Gutenberg—University Mainz, 55131 Mainz, Germany;
- Oral Pathology Department, Faculty of Dentistry, Alexandria University, Alexandria 5372066, Egypt
| | - Lara Salzer
- Department of Otorhinolaryngology Head and Neck Surgery, Molecular and Cellular Oncology, University Medical Center, 55131 Mainz, Germany; (L.S.); (R.H.S.)
| | - Eik Schiegnitz
- Department of Oral and Maxillofacial Surgery, Plastic Surgery, University Medical Center of the Johannes Gutenberg—University Mainz, 55131 Mainz, Germany;
| | - Roland H. Stauber
- Department of Otorhinolaryngology Head and Neck Surgery, Molecular and Cellular Oncology, University Medical Center, 55131 Mainz, Germany; (L.S.); (R.H.S.)
| | - Désirée Gül
- Department of Otorhinolaryngology Head and Neck Surgery, Molecular and Cellular Oncology, University Medical Center, 55131 Mainz, Germany; (L.S.); (R.H.S.)
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Dental Implant Treatment in Patients Suffering from Oral Lichen Planus: A Narrative Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19148397. [PMID: 35886246 PMCID: PMC9316128 DOI: 10.3390/ijerph19148397] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Revised: 06/30/2022] [Accepted: 07/08/2022] [Indexed: 12/16/2022]
Abstract
BACKGROUND The aim of this study was to describe the complications and survival rates of dental implants placed in patients suffering from oral lichen planus (OLP) and to present recommendations for implant treatment in this group of patients through a narrative review of the published studies. METHODS A search of the literature was conducted using four databases: PubMed/Medline, Web of Science, Cochrane, and Scopus with a stop date of May 2022. RESULTS Eighteen studies were evaluated. The results showed that dental implant survival rates in patients with OLP were similar to those reported in the general population. Moreover, the existing literature seemed to imply that OLP is not a suspected risk factor for peri-implant diseases. However, patients suffering from erosive forms of OLP or desquamative gingivitis and poor oral hygiene were more susceptible to developing peri-implant diseases; in addition, oral squamous cell carcinoma was observed in a few cases of OLP. CONCLUSION With the limitations of this narrative review, dental implants may be regarded as a safe and feasible therapeutic approach to the treatment of patients with well-controlled OLP. These patients should be monitored carefully during follow-up care. Well-designed prospective trials are required to validate the present findings.
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Esimekara JFO, Perez A, Courvoisier DS, Scolozzi P. Dental implants in patients suffering from autoimmune diseases: A systematic critical review. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2022; 123:e464-e473. [PMID: 35033725 DOI: 10.1016/j.jormas.2022.01.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Accepted: 01/10/2022] [Indexed: 12/19/2022]
Abstract
PURPOSE This systematic review aimed to evaluate complications and survival rates of dental implants placed in patients suffering from autoimmune diseases. MATERIALS AND METHODS A systematic review was conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses systematic review guidelines (PRISMA), using Google scholar and PubMed electronic databases with a stop date of September 2021. The eligibility criteria included all full text human studies in the English language literature reporting on patients with autoimmune diseases treated with dental implants. RESULTS Fifty-five studies reporting on nine distinct autoimmune diseases were analyzed: 17 on Sjögren's syndrome (SS), 11 on oral lichen planus (OLP), 8 on Type 1 diabetes, 6 on rheumatoid arthritis (RA), 4 on systemic scleroderma (SSc), 3 on Crohn's disease (CD), 3 on systemic lupus erythematosus (SLE), 2 on mucous membrane pemphigoid (MMB) and 1 on pemphigus vulgaris (PV). Despite the heterogeneity and methodological limitations of most of the studies, results showed that dental implant survival rates were comparable to those reported in the general population. However, patients with secondary SS or erosive OLP were more susceptible to developing peri-mucositis and increased marginal bone loss. CONCLUSION This review suggested that dental implants may be considered as a safe and viable therapeutic option in the management of edentulous patients suffering from autoimmune diseases. Nevertheless, scrupulous maintenance of oral hygiene and long-term follow-up emerge as being the common determinants for uneventful dental implant treatment.
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Affiliation(s)
| | - Alexandre Perez
- Division of Oral and Maxillofacial Surgery, Department of Surgery, Unit of Oral Surgery and Implantology, University of Geneva and University Hospitals of Geneva, Geneva, Switzerland
| | - Delphine S Courvoisier
- Division of Oral and Maxillofacial Surgery, Department of Surgery, University of Geneva and University Hospitals of Geneva, Geneva, Switzerland
| | - Paolo Scolozzi
- Division of Oral and Maxillofacial Surgery, Department of Surgery, University of Geneva and University Hospitals of Geneva, Geneva, Switzerland.
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Anitua E, Alkhraisat MH, Piñas L, Torre A, Eguia A. Implant-prosthetic treatment in patients with oral lichen planus: A systematic review. SPECIAL CARE IN DENTISTRY 2021; 42:60-72. [PMID: 34245172 DOI: 10.1111/scd.12629] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 06/04/2021] [Accepted: 06/23/2021] [Indexed: 01/23/2023]
Abstract
AIMS This review is aiming on identifying the ideal implant-prosthetic treatment design in patients with OLP. METHODS AND RESULTS A systematic review was conducted using four electronic databases; Medline (PubMed), Cochrane library, DOAJ and SCOPUS, following the PRISMA statement recommendations to answer the PICO question: "which implant-prosthetic treatment design is most useful to ensure implant survival in OLP patients?". The study was pre-registered in PROSPERO (CRD 42020220102). Included articles quality was assessed using the "Newcastle-Ottawa scale" and the JBI critical appraisal tool for case series. No article was found specifically designed to analyze the prosthetic influence on implant survival in OLP patients. Despite, information about implant-prostheses in studies designed with other goals was compiled. Eight articles that involved 141 patients and 341 implants were finally selected. The weighted mean follow-up was 38 months and the weighted mean survival of the implants 98.9%. No statistical differences were observed between cemented or screw retained prostheses and the materials employed or the technology to manufacture the prostheses. CONCLUSION The influence of prosthetic design on implant survival in OLP patients is still poorly understood, but important clinical recommendations can be drawn. The strength of evidence was grade 3b (CEBM) or low (GRADE).
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Affiliation(s)
- Eduardo Anitua
- Oral Surgery, Clínica Eduardo Anitua, Vitoria, Spain.,Clinical Oral Research, Fundación Eduardo Anitua, Vitoria, Spain.,Regnerative Medicine, BTI Biotechnology Institute, Vitoria, Spain
| | | | - Laura Piñas
- Oral Surgery, Clínica Eduardo Anitua, Vitoria, Spain
| | - Aintzane Torre
- Oral Surgery, Clínica Eduardo Anitua, Vitoria, Spain.,Clinical Oral Research, Fundación Eduardo Anitua, Vitoria, Spain.,Stomatology, University of the Basque Country UPV/EHU, Leioa, Spain
| | - Asier Eguia
- Clinical Oral Research, Fundación Eduardo Anitua, Vitoria, Spain.,Stomatology, University of the Basque Country UPV/EHU, Leioa, Spain
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Xiong X, Xu T, Wang X, Qin W, Yu T, Luo G. Is oral lichen planus a risk factor for peri-implant diseases? A systematic review and meta-analysis. BMC Oral Health 2020; 20:150. [PMID: 32434508 PMCID: PMC7240920 DOI: 10.1186/s12903-020-01134-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Accepted: 05/06/2020] [Indexed: 12/31/2022] Open
Abstract
Background To evaluate whether oral lichen planus (OLP) is a risk factor for peri-implant diseases (PIDs) with a systematic review and meta-analysis. Methods Five electronic databases including Medline, Embase, Web of Science, the Cochrane Library and Scopus were searched. The included studies are observational human studies written in English. The population of interest included those with/without OLP who received dental implant treatment. The follow-up time after implantation was from 1 month to 20 years. The quality of the included articles regarding risk of bias and methodology were assessed with the Newcastle-Ottawa Scale or the Agency for Healthcare Research and Quality. The data involving exposure (OLP), primary outcomes (implants having PIDs) and secondary outcomes (probing depth/PD, bleeding on probing/BOP and bone loss/BL) and potential confounders were extracted. Heterogeneity was assessed by I2 test. Dichotomous data are expressed as the risk ratio (RR) and 95% confidence interval (CI) which were calculated with a fixed effect model. Results Of the 66 articles, two studies were enrolled and evaluated as high quality, which totally contained 68 participants receiving 222 (OLP vs. non-OLP, 112 vs. 110) implants with 12 to 120-month follow-up time. Proportions of implants with PIDs between OLP and non-OLP groups were as follows: 19.6% (22/112) vs. 22.7% (25/110) for PIM and 17.0% (19/112) vs. 10.9% (12/110) for PI. The meta-analysis revealed no recognizable difference in number of implants with PIDs (PI: RR = 1.49, 95% CI 0.77–2.90, P = 0.24; PIM:RR = 0.88, 95% CI 0.53–1.46, P = 0.61; PIDs: RR = 1.08, 95% CI 0.75–1.55, P = 0.68) or BOP (RR = 0.90, 95% CI: 0.70–1.15, P = 0.40) between OLP and non-OLP groups. Conclusions Available articles regarding the effects of OLP on PIDs remains very limited. Existing evidence does not support OLP as a suspected risk factor for PIDs. Large-scale prospective trials are required to validate the findings.
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Affiliation(s)
- Xiaoqin Xiong
- Department of Periodontology and Oral Medicine, Key Laboratory of Oral Medicine, Guangzhou Institute of Oral Disease, Stomatology Hospital of Guangzhou Medical University, NO.195 Dongfeng West Road, Guangzhou, 510140, China
| | - Tiantian Xu
- Department of Periodontology and Oral Medicine, Key Laboratory of Oral Medicine, Guangzhou Institute of Oral Disease, Stomatology Hospital of Guangzhou Medical University, NO.195 Dongfeng West Road, Guangzhou, 510140, China
| | - Xinhong Wang
- Department of Periodontology and Oral Medicine, Key Laboratory of Oral Medicine, Guangzhou Institute of Oral Disease, Stomatology Hospital of Guangzhou Medical University, NO.195 Dongfeng West Road, Guangzhou, 510140, China
| | - Wenguang Qin
- Department of Periodontology and Oral Medicine, Key Laboratory of Oral Medicine, Guangzhou Institute of Oral Disease, Stomatology Hospital of Guangzhou Medical University, NO.195 Dongfeng West Road, Guangzhou, 510140, China
| | - Ting Yu
- Department of Periodontology and Oral Medicine, Key Laboratory of Oral Medicine, Guangzhou Institute of Oral Disease, Stomatology Hospital of Guangzhou Medical University, NO.195 Dongfeng West Road, Guangzhou, 510140, China.
| | - Gang Luo
- Department of Periodontology and Oral Medicine, Key Laboratory of Oral Medicine, Guangzhou Institute of Oral Disease, Stomatology Hospital of Guangzhou Medical University, NO.195 Dongfeng West Road, Guangzhou, 510140, China.
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Chrcanovic BR, Cruz AF, Trindade R, Gomez RS. Dental Implants in Patients with Oral Lichen Planus: A Systematic Review. ACTA ACUST UNITED AC 2020; 56:medicina56020053. [PMID: 32012782 PMCID: PMC7073739 DOI: 10.3390/medicina56020053] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2019] [Revised: 01/18/2020] [Accepted: 01/25/2020] [Indexed: 12/22/2022]
Abstract
Background and Objectives: To integrate the available published data on patients with oral lichen planus (OLP) rehabilitated with dental implants, as well as to review the recommendations for OLP patients receiving implants. Materials and Methods: An electronic search was undertaken in February 2019 using five databases. Publications reporting cases of patients with OLP and rehabilitated with implant-supported oral prosthesis were included. Results: Twenty-two publications were included (230 patients, 615 implants). The overall implant failure rate was 13.9% (85/610). In patients with oral squamous cell carcinoma (OSCC) the failure rate was 90.6% (29/32), but none of these implants lost osseointegration; instead, the implants were removed together with the tumor. One study presented a very high implant failure rate, 76.4% (42/55), in patients with “active lichen planus”, with all implants failing between 7–16 weeks after implant placement, and its conflicting and incongruent results are discussed in detail. There was a statistically significant difference between the failure rates in implants installed in different jaws (maxilla/mandible) and when implants of different surfaces were used (turned/moderately rough), but not between patients with reticular or erosive OLP types, or between male and female patients. If OSCC patients and the cases of the latter study are not considered, then the failure rate becomes very low (2.7%, 14/523). The time between implant placement and failure was 25.4 ± 32.6 months (range 1–112). The mean ± SD follow-up was 58.9 ± 26.7 months (1–180). Conclusions: When the results of the one study with a very high failure rate and of the cases that developed OSCC are not considered, the dental implant failure rate in OLP patients was 2.7% after a follow-up of approximately five years. Recommendations are given when treating OLP patients with dental implants.
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Affiliation(s)
- Bruno Ramos Chrcanovic
- Department of Prosthodontics, Faculty of Odontology, Malmö University, 214 21 Malmö, Sweden
- Correspondence:
| | - Aline Fernanda Cruz
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, Brazil; (A.F.C.); (R.S.G.)
| | - Ricardo Trindade
- Department of Prosthodontics, Faculty of Odontology, The Sahlgrenska Academy, University of Gothenburg, 405 30 Gothenburg, Sweden;
| | - Ricardo Santiago Gomez
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, Brazil; (A.F.C.); (R.S.G.)
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