Dental implants versus removable prostheses for the management of edentulous sites in patients with florid cemento-osseous dysplasia: A systematic review of literature with a follow-up period of at least 3 years

Purpose: To compare the medium- and long-term efficacy of implants and removable prostheses used to manage edentulous patients with florid cemento-osseous dysplasia.
Materials and methods: The PubMed, Web of Science and Google Scholar databases were searched from December 2022 to March 2023. Two independent reviewers completed the search using a population, intervention, comparison, outcome and time questionnaire. Articles were selected based on strict inclusion and exclusion criteria. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses workflow was employed to represent the number of included and excluded articles. The risk of bias was analysed using the Joanna Briggs Institute Critical Appraisal Checklist. From the included articles, the following information was extracted: demographics, concurrent medical conditions, characteristics of florid cemento-osseous dysplasia (clinical, radiographic and histological), interventions performed on the edentulous sites (placement of implants or removable prostheses), outcomes after the interventions (complications, success, bone loss, implant loss and relapse) and follow-up period.
Results: Six articles were included in the final analysis, and implants and removable prostheses were the devices reported to have been used to restore the edentulous sites. Eleven implants were placed in patients with florid cemento-osseous dysplasia, with a survival rate of 91%. Three out of three removable prostheses were delivered and all resulted in symptoms and required surgical interventions.
Conclusions: Removable prostheses in patients with florid cemento-osseous dysplasia can present complications. Implant placement within the florid cemento-osseous dysplasia lesion is unpredictable and can result in radiolucency and implant loss; meanwhile, implant placement outside of the lesion has shown favourable medium-term results. Data are limited on the long-term efficacy of implants and removable prostheses in managing edentulous sites in patients with florid cemento-osseous dysplasia.