Abstract
Introduction: Implant peri-apical lesion is a peri-implant complication characterized by radiographic bone loss around the implant apex. Different approaches have been proposed for the treatment of implant peri-apical lesions, including periapical surgery and regenerative surgery with or without resection of the implant apex. Method: In this systematic review, we searched the available literature on implant apical lesions using the PubMed database and described the possible etiologies and treatments of two implant peri-apical lesions that occurred at different stages of osteointegration. Case Report: Two patients presented to our clinic with pain and swelling 16 days and 7 months after implant surgery. In both patients, the operation site was opened, granulation tissues were removed and the area was irrigated with sterile saline. In the second patient, graft and membrane application was performed additionally. Both sites were closed primerally. Conclusion: No complications were observed at either site during the follow-up period. Therefore, both approaches can be considered effective in the treatment of implant peri-apical lesions.
Ethical Statement
Ethics committee approval is not required for this study.
References
- 1. Gadzo N, Ioannidis A, Naenni N, Hüsler J, Jung RE, Thoma DS. Survival and complication rates of two dental implant systems supporting fixed restorations: 10-year data of a randomized controlled clinical study. Clin Oral Investig 2023;27(12):7327-7327.
- 2. Gupta R, Gupta N, Weber KK. Dental Implants. In StatPearls. StatPearls Publishing.
- 3. Hämmerle CHF, Cordaro L, Alccayhuaman KAA, Botticelli D, Esposito M, Colomina LE, Gil A, Gulje FL, Ioannidis A, Meijer H, Papageorgiou S, Raghoebar G, Romeo E, Renouard F, Storelli S, Torsello F, Wachtel H. Biomechanical aspects: Summary and consensus statements of group 4. The 5th EAO Consensus Conference 2018. Clin Oral Implants Res 2018;29 Suppl 18:326-331.
- 4. Sinjari B, D'Addazio G, Santilli M, D'Avanzo B, Rexhepi I, Scarano A, Traini T, Piattelli M, Caputi S. A 4 year human, randomized, radiographic study of scalloped versus non-scalloped cemented implants. Materials 2020;13:2190.
- 5. Dilsiz A, Zihni M, Yavuz MS. Peri-implant Disease; A Review. Cumhuriyet Dent J 2023;11(1):59-65.
- 6. Kornman KS, Tonetti MS. Proceedings of the World Workshop on the Classification of Periodontal and Peri-implant Diseases and Conditions. J Clin Periodontol 2018;45(S20).
- 7. Zitzmann NU, Berglundh T. Definition and prevalence of peri-implant diseases. J Clin Periodontol 2008;35:286-291.
- 8. Berglundh T, Armitage G, Araujo MG, Avila-Ortiz G, Blanco J, Camargo PM, Chen S, Cochran D, Derks J, Figuero E, Hämmerle CHF, Heitz-Mayfield LJA, Huynh-Ba G, Iacono V, Koo KT, Lambert F, McCauley L, Quirynen M, Renvert S, Salvi GE, Schwarz F, Tarnow D, Tomasi C, Wang HL, Zitzmann N. Peri-implant diseases and conditions: Consensus report of workgroup 4 of the 2017 world workshop on the classification of periodontal and peri-implant diseases and conditions. J Periodontol 2018;89:S313-S318.
- 9. Derks J, Tomasi C. Peri-implant health and disease; a systematic review of current epidemiology. J Clin Periodontol 2015;42:158-171.
- 10. McAllister BS, Masters D, Meffert RM. Treatment of implants demonstrating peri-apical radiolucencies. Pract Periodontics Aesthet Dent 1992;4(9):37-41.
- 11. Quirynen M, Vogels R, Alsaadi G, Naert I, Jacobs R, Van Steenberghe D. Predisposing conditions for retrograde peri-implantitis, and treatment suggestions. Clin Oral Implants Res 2005;16:599-608.
- 12. Di Murro B, Papi P, Passarelli PC, D’Addona A, Pompa G. Attitude in radiographic post-operative assessment of dental implants among italian dentists: a cross-sectional survey. Antibiotics 2020;9(5):e234.
- 13. Blaya-Tarraga JA, Cervera-Ballester J, Penarrocha-Oltra D, Penarrocha-Diago M. Periapical implant lesion: A systematic review. Med Oral Patol Oral Cir Bucal 2017;22:e737-e749.
- 14. Penarrocha-Diago M, Penarrocha-Diago M, Blaya-Tarraga JA. State of the art and clinical recommendations in periapical implant lesions. 9th Mozo-Grau Ticare Conference in Quintanilla, Spain. J Clin Exp Dent 2017;9:e471-e473.
- 15. Penarrocha-Oltra D, Blaya-Tarraga JA, Menendez-Nieto I, Penarrocha-Diago M, Penarrocha-Diago M. Factors associated with early apical peri-implantitis: A retrospective study covering a 20-year period. Int J Oral Implantol 2020;13:65-73.
- 16. Burdurlu MC, Dagasan VC, Tunc O, Guler N. Retrograde peri-implantitis: Evaluation and treatment protocols of a rare lesion. Quintessence Int. 2021;52:112-121.
- 17. Lopez-Martinez F, Gomez Moreno G, Olivares-Ponce P, Eduardo Jaramillo D, Eduardo Mate Sanchez de Val J, Calvo-Guirado JL. Implants failures related to endodontic treatment. An observational retrospective study. Clin Oral Implant Res 2015;26(9):992-995.
- 18. Chang LC. Implant Periapical Lesion: A Narrative Review. Technologies 2021;9:65.
- 19. Di Murro B, Canullo L, Pompa G, Di Murro C, Papi P. Prevalence and treatment of retrograde peri-implantitis: a retrospective cohort study covering a 20-year period. Clin Oral Investig 2021;25(7):4553-4561.
- 20. Sussman HI, Moss SS. Localized osteomyelitis secondary to endodontic-implant pathosis. A case report. J Periodontol 1993;64:306-310.
- 21. Temmerman A, Lefever D, Teughels W, Balshi TJ, Balshi SF, Quirynen M. Etiology and treatment of periapical lesions around dental implants. Periodontol 2000 2014;66(1):247-254.
- 22. Chaffee NR, Lowden K, Tiffee JC, Cooper LF. Periapical abscess formation and resolution adjacent to dental implants: a clinical report. J Prosthet Dent 2001;85:109-12.
- 23. Scarano A, Di Domizio P, Petrone G, Iezzi G, Piattelli A. Implant periapical lesion: a clinical and histologic case report. J Oral Implantol 2000;26:109-113.
- 24. Lefever D, Van Assche N, Temmerman A, Teughels W, Quirynen M. Aetiology, microbiology and therapy of periapical lesions around oral implants: a retrospective analysis. J Clin Periodontol 2013;40:296-302.
- 25. Peñarrocha-Diago M, Boronat-López A, Lamas-Pelayo J. Update in dental implant periapical surgery. Med Oral Patol Oral Cir Bucal 2006;11:e429-432.
- 26. Di Murro B, Papi P, Di Murro C, Pompa G, Gambarini G. Correlation between endodontic pulpal/periapical disease and retrograde peri-implantitis: A case series. Aust Endod J 2021;47(2):358-364.
- 27. Peñarrocha-Diago MA, Maestre-Ferrín L, Cervera-Ballester J, Peñarrocha-Oltra D. Implant periapical lesion: diagnosis and treatment. Med Oral Patol Oral Cir Bucal 2012;17 (6):e1023-1027.
- 28. Reiser GM, Nevins M. The implant periapical lesion: etiology, prevention, and treatment. Compend Contin Educ Dent 1995;16:768-772.
- 29. Marshall G, Canullo L, Logan RM, Rossi-Fedele G. Histopathological and microbiological findings associated with retrograde peri-implantitis of extra-radicular endodontic origin: A systematic and critical review. Int J Oral Maxillofac Surg 2019;48(11):1475-1484.
- 30. Feller L, Jadwat Y, Chandran R, Lager I, Altini M, Lemmer J. Radiolucent inflammatory implant periapical lesions: A review of the literature. Implant Dent 2014;23:745-752.
- 31. Balshi SF, Wolfinger GJ, Balshi TJ. A retrospective evaluation of a treatment protocol for dental implant periapical lesions: Long-term results of 39 implant apicoectomies. Int J Oral Maxillofac Implant 2007;22:267-272.
- 32. Dahlin C, Nikfarid H, Alse’n B, Kashani H. Apical peri-implantitis: Possible predisposing factors, case reports, and surgical treatment suggestions. Clin Implant Dent Relat Res 2009;11:222-227.
- 33. Chan HL, Wang HL, Bashutski JD, Edwards PC, Fu JH, Oh TJ. Retrograde peri-implantitis: A case report introducing an approach to its management. J Periodontol 2011;82:1080-1088.
- 34. Rodríguez A, Rodríguez F. Proceso periapical implantológico. Rev Esp Odontostomatológico de Implantes 1995;3:159-162.
- 35. Rosendahl K, Dahlberg G, Kisch J, Nilner K. Implant periapical lesion. A case series report. Swed Dent J 2009;33(2):49-58.
- 36. Palma-Carrió C, Maestre-Ferrín L, Peñarrocha-Oltra D, Peñar¬rocha-Diago MA, Peñarrocha-Diago M. Risk factors associated with early failure of dental implants. A literature review. Med Oral Patol Oral Cir Bucal 2011;16:e514-517.
- 37. Waasdrop J, Reynolds M. Nonsurgical treatment of retrogradeperi-implantitis: a case report. Int J Oral Maxillofac Implants 2010;25:831-833.
- 38. Peñarrocha-Diago M, Boronat-Lopez A, García-Mira B. Inflammatory implant periapical lesion: etiology, diagnosis, and treatment presentation of 7 cases. J Oral Maxillofac Surg 2009;67:168-173.
- 39. Romanos GE, Froum S, Costa-Matins S, Meitner S, Tarnow DP. Implant periapical lesions: Etiology and treatment options. J Oral Implantol 2011;37:53-63.
- 40. Zhou Y, Cheng Z, Wu M, Hong Z, Gu Z. Trepanation and curettage treatment for acute implant periapical lesions. Int J Oral Maxillofac Surg. 2012;41:171-175.
- 41. 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.
- 42. Tözüm TF, Sençimen M, Ortakoğlu K, Ozdemir A, Aydin OC, Keleş M. Diagnosis and treatment of a large periapical implant lesion associated with adjacent natural tooth: a case report. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2006;101:132-138.
- 43. Bretz WA, Matuck AN, de Oliveira G, Moretti AJ, Bretz WA. Treatment of retrograde peri-implantitis: clinical report. Implant Dent 1997;6(4):287-290.
- 44. Kutlu HB, Genc T, Tozum TF. Treatment of refractory apical peri-implantitis: A case report. J Oral Implantol 2016;42: 104-109.
- 45. Sahrmann P, Ronay V, Hofer D, Attin T, Jung RE, Schmidlin PR. In vitro cleaning potential of three different implant debridement methods. Clin Oral Implants Res 2015;26(3):314-319.
- 46. Sussman HI. Periapical implant pathology. J Oral Implantol 1998;24:133-138.
- 47. Piattelli A, Scarano A, Balleri P, Favero GA. Clinical and histologic evaluation of anactive “implant periapical lesion”: a case report. Int J Oral Maxillofac Implants 1998;13:713-716.
- 48. Piattelli A, Scarano A, Piattelli M, Poda G. Implant periapical lesions: clinical, histologic, and histochemical aspects. A case report. Int J Periodontics Restorative Dent 1998;18:181-187.
- 49. Oh TJ, Yoon J, Wang HL. Management of the implant periapical lesion: a case report. Implant Dent 2003;12:41-46.
- 50. Franceschi D, Giuliani V, Giuntini V, Pini Prato GP, Chambrone L. Retrograde Peri-implantitis: Report of a Case Successfully Treated by Resection of the Implant Apex. Int J Periodontics Restor Dent. 2021;41:443-448.
Details
| Primary Language | English |
|---|---|
| Subjects | Oral Implantology, Periodontics |
| Journal Section | Review |
| Authors | |
| Publication Date | September 30, 2025 |
| Submission Date | January 28, 2025 |
| Acceptance Date | May 20, 2025 |
| Published in Issue | Year 2025 Volume: 28 Issue: 3 |
Cumhuriyet Dental Journal (Cumhuriyet Dent J, CDJ) is the official publication of Cumhuriyet University Faculty of Dentistry. CDJ is an international journal dedicated to the latest advancement of dentistry. The aim of this journal is to provide a platform for scientists and academicians all over the world to promote, share, and discuss various new issues and developments in different areas of dentistry. First issue of the Journal of Cumhuriyet University Faculty of Dentistry was published in 1998. In 2010, journal's name was changed as Cumhuriyet Dental Journal. Journal’s publication language is English.
CDJ accepts articles in English. Submitting a paper to CDJ is free of charges. In addition, CDJ has not have article processing charges.
Frequency: Four times a year (March, June, September, and December)
IMPORTANT NOTICE
All users of Cumhuriyet Dental Journal should visit to their user's home page through the "https://dergipark.org.tr/tr/user" " or "https://dergipark.org.tr/en/user" links to update their incomplete information shown in blue or yellow warnings and update their e-mail addresses and information to the DergiPark system. Otherwise, the e-mails from the journal will not be seen or fall into the SPAM folder. Please fill in all missing part in the relevant field.
Please visit journal's AUTHOR GUIDELINE to see revised policy and submission rules to be held since 2020.