Implant treatment in patients with oral lichen planus: a prospective-controlled study Gonzalo Herna ´ndez Rosa Marı´a Lopez-Pintor Lorenzo Arriba Jesu ´s Torres Juan Carlos de Vicente Author’s affiliations: Gonzalo Herna ´ndez, Rosa Marı´a Lopez-Pintor, Lorenzo Arriba, Department of Oral Medicine and Orofacial Surgery, Faculty of Odontology, Complutense University, Madrid, Spain Jesu ´s Torres, Department of Health Sciences III, Faculty of Health Sciences, Rey Juan Carlos University, Alcorco ´n, Spain Juan Carlos de Vicente, Department of Oral and Maxillofacial Surgery, University Hospital of Asturias, Faculty of Medicine and Dentistry, Oviedo, Spain Corresponding author: Prof. Gonzalo Hernandez Departamento de Medicina y Cirugı ´a Bucofacial Facultad de Odontologı ´a Ciudad Universitaria s/n 28040 Madrid Spain Tel. þ 34 1394 2013 Fax: þ 34 1 308 5232 e-mail: ghervall@odon.ucm.es Key words: complications, dental implants, desquamative gingivitis, lichen planus, local factors, mucosal disturbances, peri-implant mucositis, peri-implantitis Abstract Objectives: The main aim of this prospective-controlled study was to evaluate the implant survival rate in patients diagnosed with oral lichen planus (OLP). The secondary goals were to analyze the presence of implant- and patient-dependent variables. Material and methods: Two groups, including 18 patients diagnosed with OLP and 18 controls, received 56 and 62 implants during the years 2003–2008. Pain and wound healing were evaluated after the procedure. After a mean follow-up of 53.5 and 52.3 months, clinical and radiographic assessments were used to evaluate implant survival and patient- and implant-dependent parameters. Results: The implant survival rate was 100% for the OLP group. Immediate postsurgical complications were similar in both groups. Peri-implant mucositis (PIM) was detected in 44.6% of the implants and 66.6% of the patients with OLP. The presence of desquamative gingivitis (DG) was associated with a higher rate of PIM on those implants of the OLP group (P ¼ 0.004). Peri-implantitis (PI) appeared in 10.7% of the implants and 27.7% of the patients with OLP (P ¼ NS). Conclusion: Despite the limitations of the small sample size, it seems that lichen planus is not a prominent local player in the genesis of implant failure. Patients with DG should be carefully examined during follow-up care. Dental implants are routinely used to treat full or partial edentulism with a high rate of success. Early absolute and relative contraindications for implant therapy included many local and sys- temic diseases, the collection of which is gradu- ally shrinking as these conditions are shown to have less influence on implant course than was previously thought. These include osteoporosis, diabetes, immunosuppression, bone diseases, gastrointestinal problems, leukemia, and other systemic and congenital diseases (O ¨ czakir et al. 2005; Dowell et al. 2007; Alsaadi et al. 2008a, 2008b; Holahan et al. 2008; Javed & Romanos 2009; Torres et al. 2009). Implant success mainly depends on factors related to bone quality and quantity, but other variables such as those invol- ving soft tissues may have some influence on implant survival and bone loss (BL). The mar- ginal area of the implant is the site where early BL usually occurs and the ability of the epithelium to adhere and seal this area is critical to main- taining a healthy peri-implant environment (Le- kholm 1997). The presence of a healthy mucosa is therefore the ideal in cases where dental im- plants have to be placed, to minimize the pre- sence of peri-implant soft tissue complications. Local mucosal conditions may contribute to implant failure (Hernandez et al. 2009), and some authors have hypothesized that the presence of these disorders may be biological and local con- traindications for implant placement (Zoldos & Kent 1995; Esposito et al. 1998). Oral lichen planus (OLP) is a mucocutaneous autoimmune inflammatory disease with varied clinical mani- festations (Thorn et al. 1988) that occurs in approximately 2.0% of the general population (Axe ´ll & Rundquist 1987). Its etiopathogenesis includes several cell-mediated immune pathways resulting in damage of the epithelium and con- nective tissue, although the exact etiology of this condition is still unexplained. Only two papers dealing with the course of dental implants in patients with OLP are available in the literature when OLP and dental implants are entered as the search criteria in PubMed (Esposito et al. 2003; Reichart 2006). Two other cases of OLP patients receiving implant treatment have been published included in two series of cases (Esposito et al. 2000; O ¨ czakir et al. 2005), and one was asso- ciated with two late implant failures (Esposito et al. 2000). It is also important to emphasize the risk of malignancies, which is an important Date: Accepted 16 March 2011 To cite this article: Herna ´ndez G, Lopez-Pintor RM, Arriba L, Torres J, de Vicente JC. Implant treatment in patients with oral lichen planus: A prospective-controlled study. Clin. Oral Impl. Res. xx, 2011; 000–000. doi: 10.1111/j.1600-0501.2011.02192.x c  2011 John Wiley & Sons A/S 1