The Journal of the Korean dental association (대한치과의사협회지)

The Korean Dental Association (대한치과의사협회)
권호 표지

Diagnosis and Clinical Management of Retrograde Peri-Implantitis Associated with Adjacent Apical Periodontitis: a Case Report

  • Lee, Kwan-Joo (Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry) ;
  • Song, Young Woo (Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry) ;
  • Jung, Ui-Won (Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry) ;
  • Cha, Jae-Kook (Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry)
  • Received : 2020.02.07
  • Accepted : 2020.03.20
  • Published : 2020.05.31
Download PDF
⟨ Previous Next ⟩

Abstract

Peri-apical implant lesion, also known as 'retrograde peri-implantitis' can occur with multifactorial etiological factors. The purpose of this case report is to demonstrate resolution of periapical implant lesion by removal of causative factors and saving implant by regenerative therapy. A 54-year old male patient with mild dull pain around implant on the right mandibular second premolar area due to persistent peri-apical infection of the adjacent first premolar was treated. Extraction of tooth with symptomatic apical periodontitis and regenerative therapy on the buccal fenestration area of the implant and extraction site were performed. After 6-month reentry, notable regenerated bone tissue around implant was found, and implant placement on the previous extraction site was performed. After 14-month follow-up from the regenerative therapy, neither biological nor mechanical complication could be found around the implant, evidenced by high implant stability, normal clinical probing depth, and absence of discomfort spontaneously and during masticatory function. In conclusion, surgical intervention including regenerative therapy using bone graft and barrier membrane on periapical implant lesion can be suggested as one of the treatment options considering the extent of periapical lesion.

Keywords

Acknowledgement

This work was supported by a National Research Foundation of Korea (NRF) grant funded by the Korean government (Ministry of Science, ICT & Future Planning) (No. NRF-2017R1A2B2002537).

References

  1. Ayangco L, Sheridan PJ. Development and treatment of retrograde peri-implantitis involving a site with a history of failed endodontic and apicoectomy procedures: a series of reports. Int J Oral Maxillofac Implants 2001;16(3):412-417
  2. McAllister BS, Masters D, Meffert RM. Treatment of implants demonstrating periapical radiolucencies. Pract Periodontics Aesthet Dent 1992;4(9):37-41
  3. Reiser GM, Nevins M. The implant periapical lesion: etiology, prevention, and treatment. Compend Contin Educ Dent 1995;16(8):768, 770, 772 passim
  4. van Steenberghe D, Yoshida K, Papaioannou W, et al. Complete nose coverage to prevent airborne contamination via nostrils is unnecessary. Clin Oral Implants Res 1997;8(6):512-516 https://doi.org/10.1034/j.1600-0501.1997.080610.x
  5. Lefever D, Van Assche N, Temmerman A, et al. Aetiology, microbiology and therapy of periapical lesions around oral implants: a retrospective analysis. J Clin Periodontol 2013;40(3):296-302 https://doi.org/10.1111/jcpe.12045
  6. Chang LC, Hsu CS, Lee YL. Successful medical treatment of an implant periapical lesion: a case report. Chang Gung Med J 2011;34(1):109-114
  7. Dahlin C, Nikfarid H, Alsen B, Kashani H. Apical peri-implantitis: possible predisposing factors, case reports, and surgical treatment suggestions. Clin Implant Dent Relat Res 2009;11(3):222-227 https://doi.org/10.1111/j.1708-8208.2008.00108.x
  8. Sarmast ND, Wang HH, Sajadi AS, et al. Classification and Clinical Management of Retrograde Peri-implantitis Associated with Apical Periodontitis: A Proposed Classification System and Case Report. J Endod 2017;43(11):1921-1924 https://doi.org/10.1016/j.joen.2017.06.034
  9. Sussman HI. Endodontic pathology leading to implant failure--a case report. J Oral Implantol 1997;23(3):112-115; discussion 115-116
  10. Waasdorp J, Reynolds M. Nonsurgical treatment of retrograde peri-implantitis: a case report. Int J Oral Maxillofac Implants 2010;25(4):831-833
  11. Silva GC, Oliveira DR, Vieira TC, et al. Unusual presentation of active implant periapical lesions: a report of two cases. J Oral Sci 2010;52(3):491-494 https://doi.org/10.2334/josnusd.52.491
  12. Sussman HI. Tooth devitalization via implant placement: a case report. Periodontal Clin Investig 1998;20(1):22-24
  13. Oh TJ, Yoon J, Wang HL. Management of the implant periapical lesion: a case report. Implant Dent 2003;12(1):41-46 https://doi.org/10.1097/01.ID.0000042508.60701.76
  14. Zhou Y, Cheng Z, Wu M, et al. Trepanation and curettage treatment for acute implant periapical lesions. Int J Oral Maxillofac Surg 2012;41(2):171-175 https://doi.org/10.1016/j.ijom.2011.09.013
  15. Ataullah K, Chee LF, Peng LL, Lung HH. Management of retrograde peri-implantitis: a clinical case report. J Oral Implantol 2006;32(6):308-312 https://doi.org/10.1563/0-802.1
  16. Chan HL, Wang HL, Bashutski JD, et al. Retrograde peri-implantitis: a case report introducing an approach to its management. J Periodontol 2011;82(7):1080-1088 https://doi.org/10.1902/jop.2010.100585
  17. Penarrocha-Diago M, Boronat-Lopez A, Garcia-Mira B. Inflammatory implant periapical lesion: etiology, diagnosis, and treatment--presentation of 7 cases. J Oral Maxillofac Surg 2009;67(1):168-173 https://doi.org/10.1016/j.joms.2007.12.022
  18. Bretz WA, Matuck AN, de Oliveira G, et al. Treatment of retrograde peri-implantitis: clinical report. Implant Dent 1997;6(4):287-290 https://doi.org/10.1097/00008505-199700640-00004
  19. Quirynen M, Vogels R, Alsaadi G, et al. Predisposing conditions for retrograde peri-implantitis, and treatment suggestions. Clin Oral Implants Res 2005;16(5):599-608 https://doi.org/10.1111/j.1600-0501.2005.01147.x
  20. Cha JK, Paeng K, Jung UW, et al. The effect of five mechanical instrumentation protocols on implant surface topography and roughness: A scanning electron microscope and confocal laser scanning microscope analysis. Clin Oral Implants Res 2019;30(6):578-587 https://doi.org/10.1111/clr.13446