Journal of Oral Implantology December 2012 - (Page 792)

LITERATURE REVIEW Squamous Cell Carcinoma in Association With Dental Implants: An Assessment of Previously Hypothesized Carcinogenic Mechanisms and a Case Report Neel B. Bhatavadekar, MS, MPH* Although dental implants have seen tremendous clinical success over the past few decades, there are some worrying reports in literature describing squamous cell carcinoma (SCC) in close association with dental implants. This article also provides a critical assessment of the published literature relating to the presence of carcinoma in association with dental implants, analyzing the previously published and hypothesized carcinogenic responses to an implant, to try and come to a conclusion regarding the plausibility and clinical risk for cancer formation in association with dental implants. An unusual case of an SCC noted in close proximity to a dental implant is also presented. A systematic search was conducted using Medline (PubMed), Cochrane Database, and Google Scholar with the search terms ‘‘cancer,’’ ‘‘squamous cell carcinoma,’’ ‘‘dental implant,’’ ‘‘SCC,’’ ‘‘peri-implantitis,’’ ‘‘oral cancer,’’ and ‘‘implantology’’ and using multiple combinations using Boolean operators ‘‘or’’ and ‘‘and.‘‘ The search was not limited to dental literature; orthopedic and biomedical literature was also included. The results were then hand screened to pick out the relevant articles. In total, 14 previous published reports were found, where 24 dental implants were reported to be associated with SCC. Not all the reported patients had a history of cancer, but contributory factors such as smoking were found. An analysis of the biological plausibility of previously proposed carcinogenic mechanisms, such as corrosion, metallic ion release, and particulate debris, did not support the etiologic role for dental implants in cancer development, and the standardized incidence ratio was found to be extremely low (0.00017). Peri-implantitis should be assessed cautiously in patients receiving implants who have a previous history of cancer. Dental implants are a safe treatment modality based on the published data, and any change in surgical protocol is not mandated. Key Words: dental implant, carcinogen, carcinoma INTRODUCTION T 792 his article presents an unusual case of a squamous cell carcinoma (SCC) in close association with a dental implant. Although dental implants have seen tremendous clinical success over the past few decades, the recent literature has had some reports of SCC is close association with dental implants.1–6 A recent report made a bold statement Dental Specialty Center, Bombay Hospital Research Center, Mumbai, India. * Corresponding author, e-mail: drneel1@gmail.com. DOI: 10.1563/AAID-JOI-D-11-00045 that implants can be a cause of cancer by providing a ‘‘route of entry for squamous cell carcinoma,’’1 and another report stated that dental implants can lead to SCC in at-risk patients,3 perhaps by ingress of carcinogenic ionic debris. Markets for dental implants have been estimated at $3.4 billion in 2008, and are anticipated to reach $8.1 billion by 2015.7 It is estimated that in 2008, in the United States alone, 900 000 dental implants were placed.7 Hence, as clinicians, we need to be quite concerned about such claims of cancer formation with dental implants. Some of the previous published reports1–6 obviously leave room for doubt regarding the possible relation between dental implants and cancer, with one report Vol. XXXVIII /No. Six /2012

Table of Contents for the Digital Edition of Journal of Oral Implantology December 2012

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Lateral Augmentation of the Maxilla and Mandible Using Framework Technique With Allogeneic Bone Grafts
Accuracy of Cone Beam Computerized Tomography and a Three-Dimensional Stereolithographic Model in Identifying the Anterior Loop of the Mental Nerve: A Study on Cadavers
Evaluation of Microgap Size and Microbial Leakage in the Connection Area of 4 Abutments With Straumann (ITI) Implant
Buccal Bone Plate Remodeling After Immediate Implant Placement With and Without Synthetic Bone Grafting and Flapless Surgery: Radiographic Study in Dogs
Evaluation of Soft Tissues Around Single Tooth Implants in the Anterior Maxilla Restored With Cemented and Screw-Retained Crowns
Accuracy of a Newly Developed Cone-Beam Computerized Tomography-Aided Surgical Guidance System for Dental Implant Placement: An Ex Vivo Study
Nasopalatine Canal Position Relative to the Maxillary Central Incisors: A Cone Beam Computed Tomography Assessment
Esthetics in Implant-Supported Prostheses: A Literature Review
Reliability of Implant Surgical Guides Based on Soft-Tissue Models
Clinical Evaluation of Short and Wide-Diameter Implants Immediately Placed Into Extraction Sockets of Posterior Areas: A 2-Year Retrospective Study
Single Stage Immediate Implant Placements in the Esthetic Zone
Removal of Fractured Dental Implant Screw Using a New Technique: A Case Report
Restoration of Failing Maxillary Implant-Supported Fixed Prosthesis With Cross Arch Splinted Unilateral Zygomatic Implant: A Clinical Report
Oral Rehabilitation of Severe Dentoalveolar Trauma: A Clinical Report
Implant Installation With Bone Augmentation and Transmucosal Healing With Demineralized Human Cortical Bone in the Maxillary Anterior Region: Report of 3 Cases
Bone Morphogenic Protein: An Elixir for Bone Grafting—A Review
Orthodontic Considerations in Restorative Management of Hypodontia Patients With Endosseous Implants
Squamous Cell Carcinoma in Association With Dental Implants: An Assessment of Previously Hypothesized Carcinogenic Mechanisms and a Case Report
Indirect Osteotome Maxillary Sinus Floor Elevation: An Update
Reliability of Implant Surgical Guides Based on Soft-Tissue Models: A Methodological Mistake

Journal of Oral Implantology December 2012