Dental Implants in Patients with Oral Lichen Planus: A Systematic Review

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.

Dental Implants Inserted in Fresh Extraction Sockets versus Healed Sites: A Systematic Review and Meta-Analysis

“…Last but not least, the studies present many confounding factors that may also affect the clinical outcomes of dental implants, not just the fact that implants were placed in fresh extraction sockets or healed sites. For example, we can cite the influence of implants of different diameters and lengths [189], status of the opposing dental arch, bruxism [190][191][192], diabetes [193], periodontal status [194], intake of different classes of medicaments by the patients [195][196][197][198], irradiation of the head and neck region [199], treatment performed by different professionals [200], different loading protocols [201], other diseases [202][203][204][205], type of prosthetic configuration [206][207][208], and patient's sex [209], among others. Further, individual patients sometimes present with more than one risk factor [210].…”

Oral Lichen Planus and Dental Implants: Protocol and Systematic Review

“…(iii) Finally, meticulous oral hygiene and frequent, regular appointments [ 32 ] are important to prevent inflammatory tissue response, such as mucositis or peri-implantitis, and for the early detection of malignant transformation [ 33 , 34 , 35 ].…”

Pathogen reduction technology: A novel possibility for inactivation of blood products used in oral and periodontal surgeries

“…Emergency dental treatment is given importance and elective dental procedures are postponed and the treatment is rated for its overall urgency by seeing clinically if the patient has a definite limitation in dental comfort. [ 8 ] PRF belongs to a group of platelet concentrate that is used routinely in implant surgeries for its excellent regenerative and growth factor signaling properties. The ease of preparation without extensive handling makes it a popular choice among oral surgeons and periodontists to incorporate it routinely during implant surgical procedures.…”