Background: The oncologic safety of dental implants (DIs) in patients with oral field cancerization (OFC) remains uncertain. Increasing reports of oral squamous cell carcinoma (OSCC) developing adjacent to DIs have raised concerns regarding the interaction between implants, chronic inflammation, and genetically altered mucosa. Methods: A comprehensive PubMed/MEDLINE search was performed through June 2025 to identify English- or Spanish-language publications reporting primary OSCC occurring in proximity to DIs. Extracted variables included patient demographics, tumor site, clinical presentation, presence of oral potentially malignant disorders (OPMD) or prior OSCC, peri-implant inflammation, management, and outcomes. Cases describing clinical features compatible with field-altered mucosa (e.g., OPMD or prior OSCC) were evaluated descriptively, recognizing that formal histopathologic or molecular evidence of OFC was rarely reported. Results: A total of 105 implant-associated OSCC cases were identified. The mean patient age was 66.8 years (range: 40–90), with a female predominance (1.3:1). The mandible was the most frequently involved site (86.7%). A prior history of OPMD or OSCC was reported in 53 patients (50.5%), and peri-implantitis preceding diagnosis in 21 cases (19.0%). The most common clinical presentations were exophytic (59.0%) and ulcerated (37.1%) lesions, frequently mimicking peri-implantitis and contributing to diagnostic delay. Reported outcomes included recurrence in 11 cases (10.5%) and death in 13 cases (12.4%). Conclusions: Current evidence suggests that implant-associated OSCC frequently occurs in patients with pre-existing mucosal alterations and may be influenced by the interaction of field cancerization with local inflammatory and mechanical factors. Implant rehabilitation in individuals with OPMD, prior OSCC, or epithelial dysplasia should be undertaken cautiously, with rigorous long-term surveillance to ensure oncologic safety.
背景：口腔区域癌化（OFC）患者中牙种植体（DIs）的肿瘤学安全性仍不明确。近期关于牙种植体邻近区域发生口腔鳞状细胞癌（OSCC）的报道逐渐增多，引发了人们对种植体、慢性炎症与基因异常黏膜之间相互作用的担忧。方法：通过系统检索截至2025年6月的PubMed/MEDLINE数据库，筛选报告牙种植体邻近区域发生原发性OSCC的英文或西班牙文文献。提取变量包括患者人口学特征、肿瘤部位、临床表现、口腔潜在恶性病变（OPMD）或既往OSCC病史、种植体周围炎症情况、治疗方案及预后。对符合区域黏膜改变特征（如OPMD或既往OSCC）的病例进行描述性分析，需注意文献中鲜有报道OFC的正式组织病理学或分子生物学证据。结果：共纳入105例种植体相关OSCC病例。患者平均年龄66.8岁（范围：40-90岁），女性居多（男女比例1.3:1）。下颌骨是最常见发病部位（86.7%）。53例患者（50.5%）有OPMD或OSCC病史，21例（19.0%）在确诊前存在种植体周围炎。最常见的临床表现为外生型（59.0%）和溃疡型（37.1%）病变，这些病变常与种植体周围炎表现相似，导致诊断延迟。预后数据显示复发11例（10.5%），死亡13例（12.4%）。结论：现有证据表明，种植体相关OSCC常发生于已存在黏膜病变的患者，其发生可能与区域癌化现象与局部炎症、机械因素的相互作用有关。对于存在OPMD、OSCC病史或上皮异常增生的患者，进行种植修复治疗需谨慎，并应实施严格的长期随访监测以确保肿瘤学安全性。
肿瘤(癌症)患者之家