Diagnostic Challenges of Peri-Implant Lesions in Libya

Abstract

Peri-implantitis is the most encountered complication in implant dentistry. However, emerging evidence indicates that not all peri-implant lesions are inflammatory in origin. Malignancies, particularly oral squamous cell carcinoma (OSCC), may mimic peri-implant disease both clinically and radiographically, leading to delayed diagnosis and poor prognosis. This study aims to explore the potential under-recognition of malignancies presenting as peri-implant lesions in Libya and to assess the awareness and clinical practices of dental practitioners regarding this issue. A cross-sectional survey-based study is proposed targeting Libyan dental practitioners, including general dentists and implantologists. The questionnaire evaluates knowledge, attitudes, and practices related to suspicious peri-implant lesions and biopsy referral patterns. Our study showed that variability in awareness exists among clinicians, with a tendency toward underutilization of biopsy in persistent or atypical peri-implant lesions. The absence of reported cases in Libya may reflect underdiagnosis rather than true absence. Increasing awareness and implementing clear diagnostic protocols are essential to improve early detection and patient outcomes.