Title: Non inflammatory lesions surrounding dental implants: A systematic review
Abstract:
Background: Dental implants demonstrate high long-term success rates; however, a variety of non-inflammatory peri-implant lesions may compromise implant survival and patient safety. These lesions include reactive lesions, benign and malignant neoplasms, and developmental or odontogenic cysts. Due to their rarity and frequent clinical resemblance to inflammatory peri-implant diseases, non-inflammatory lesions are often misdiagnosed or diagnosed late. This systematic review aimed to categorize and summarize the types, frequency, and clinical characteristics of non-inflammatory peri-implant lesions reported in the literature.
Methods: A comprehensive systematic search was conducted in PubMed, Scopus, Embase, Cochrane Library, Web of Science, ProQuest, and Ovid from inception until October 7, 2025. Eligible studies included human case reports, case series, and clinical studies reporting histopathologically confirmed non-inflammatory peri-implant lesions. Inflammatory conditions such as peri-implantitis and mucositis were excluded. Study selection and data extraction were performed independently by two reviewers. Methodological quality was assessed using the QUADAS-2 tool.
Results: Out of 17,440 identified records, 30 studies met the inclusion criteria, reporting a total of 166 non-inflammatory peri-implant lesions. Lesions were categorized into reactive lesions, benign neoplasms, malignant neoplasms, and developmental/odontogenic cysts. Squamous cell carcinoma was the most frequently reported malignant lesion (96 cases), followed by peripheral giant cell granuloma as the most common reactive lesion (38 cases). Most lesions occurred in the posterior mandible and affected middle-aged to elderly patients. Several local and systemic risk factors, including chronic mechanical irritation, poor oral hygiene, ill-fitting prostheses, and systemic conditions, were commonly reported.
Conclusion: Non-inflammatory peri-implant lesions represent a rare but clinically significant group of pathologies. Early recognition, histopathologic evaluation, and individualized management are essential to prevent disease progression and implant loss. Clinicians should consider biopsy in atypical or persistent peri-implant lesions to ensure accurate diagnosis and optimal patient outcomes.
