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Management of Retrograde Peri‐Implantitis by Apical Resection and Guided Bone Regeneration in Adjacent Maxillary Implants
Author(s) -
ThompsonSloan Tamika N.,
Kolhatkar Shilpa,
Bhola Monish
Publication year - 2012
Publication title -
clinical advances in periodontics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.182
H-Index - 2
eISSN - 2163-0097
pISSN - 2573-8046
DOI - 10.1902/cap.2012.110106
Subject(s) - medicine , implant , radiography , dentistry , peri implantitis , lesion , fistula , coronal plane , surgery , radiology
Retrograde peri‐implantitis (RPI) is defined as a clinically symptomatic periapical lesion that develops shortly after implant insertion while the coronal portion of the implant sustains a normal bone‐to‐implant interface. The etiology of RPI is unclear and may be attributed to several causes. Regardless of etiology, the management of RPI has been attempted by either resective or regenerative techniques. Case Presentation: A 61‐year‐old male was screened and evaluated for three maxillary anterior implants placed 10 years previously. Evaluation included a thorough periodontal and dental exam, radiographs, and cone‐beam computed tomography. Probing depths around all implants ranged from 2 to 4 mm with no bleeding on probing/mobility. The apices of implants #8 and #9 exhibited radiolucencies, and a draining fistula was associated with implant #8. Treatment consisted of sectioning and removal of the affected portion of the implants and collection of a specimen for histopathologic examination. Demineralized bone matrix putty was placed in the residual bony defects and covered with a collagen barrier. At 1 year, radiographs revealed both lesions around implants #8 and #9 appeared to be resolving. The lesion associated with implant #9 had a more remarkable radiographic change, because it was smaller than the lesion around implant #8. Both implants continued to function with no recurrence of fistula formation. Histopathologic analysis was consistent with the diagnosis of a periapical granuloma. Conclusion: Resection of the apical portion of implants is a viable treatment modality in the management of RPI.