Metastases and primary tumors around dental implants: A literature review and case report of peri-implant pulmonary metastasis

Objective: To perform a literature review on peri-implant metastases and primary malignoma and report a case of a pulmonary metastasis around dental implants of the anterior mandibular jaw that mimicked peri-implantitis. Method and Materials: A literature search of publications from June 1980 to June 2011 in the PubMed/ Medline database was performed to collect information about the type, incidence, and localization of malignant primary tumors and metastases around dental implants and to evaluate potential risk factors. A descriptive statistic was performed based on the collected data with regard to the type and/or origin of tumor, its localization, and the patient's age and sex. Results: A total of 1,795 articles were considered for evaluation. Peri-implant metastases are described in three articles, and peri-implant primary tumors were found in 14 publications. Of all peri-implant metastases, no associated risk factors are mentioned. Those of the peri-implant tumors are alterations of the peri-implant mucosa (such as oral lichen planus, verrucous leukoplakia, and ulcer). Most of the primary tumors are squamous cell carcinoma. The mean age of the patients with periimplant metastases was 68 years; for the peri-implant primary tumors, it was 71 years. Conclusion: Peri-implant metastases and primary tumors are rare. Every untypical or refractory reaction to the treatment of peri-implantitis is suspicious for malignancy as long as the contrary remains unproven. Keywords: dental implant, numb chin syndrome, peri-implantitis, primary tumor, pulmonary metastasis, risk factors