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[种植体周围炎还是鳞状细胞癌?]

[Peri-implantitis or squamous cell carcinoma?].

作者信息

Abu El-Naaj I, Trost O, Tagger-Green N, Trouilloud P, Robe N, Malka G, Peled M

机构信息

Department of Oral and Maxillofacial Surgery, Rambam Medical Center, Technion Faculty of Medicine, Haifa, Israel.

出版信息

Rev Stomatol Chir Maxillofac. 2007 Nov;108(5):458-60. doi: 10.1016/j.stomax.2007.04.004. Epub 2007 Jul 12.

Abstract

INTRODUCTION

Squamous cell carcinoma developed around dental implants has seldom been described. It simulates peri-implantitis. The authors present two cases and a literature review.

CASE REPORTS

A 70 year-old woman presented with an exophytic tumor developed around dental implants placed in the anterior part of the mandible. Panoramic X-rays showed major osteolysis, especially around the distal abutment implants. A 72 year-old patient, smoker, presented with chronic lichen planus; he was carrying two implants supporting an overdenture with ball-attachments, placed 15 years before. He presented with an ulcerated symphyseal tumor, bone loss around implant in position 43. The implant had been spontaneously pushed out. In both cases the diagnosis was squamous cell carcinoma.

DISCUSSION

Few cases of squamous cell carcinoma developed around dental implants have been reported. They initially mimic peri-implantitis. The carcinogenic role of the implant has never been established. Another hypothesis is the migration of malignant cells, originating from a mucosal tumor, through the sulcus. Risk factors for squamous cell carcinoma (smoking or alcohol consumption, precancerous lesions) are an indication for a permanent follow-up. Biopsies will prove the diagnosis.

摘要

引言

种植体周围发生的鳞状细胞癌鲜有报道。它类似种植体周围炎。作者介绍两例病例并进行文献综述。

病例报告

一名70岁女性,在下颌前部植入种植体周围出现外生性肿瘤。全景X线片显示严重骨质溶解,尤其是在远端基牙种植体周围。一名72岁吸烟患者,患有慢性扁平苔藓;他佩戴两枚支持球附着式覆盖义齿的种植体,已植入15年。他出现了溃疡型正中肿瘤,43号牙位种植体周围骨质流失。种植体已自行脱出。两例病例诊断均为鳞状细胞癌。

讨论

种植体周围发生鳞状细胞癌的病例报道较少。它们最初类似种植体周围炎。种植体的致癌作用尚未得到证实。另一种假说是起源于黏膜肿瘤的恶性细胞通过龈沟迁移。鳞状细胞癌的危险因素(吸烟或饮酒、癌前病变)提示需要进行长期随访。活检将证实诊断。

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