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

Lee,  Kwan-Joo; Song,  Young Woo; Jung,  Ui-Won; Cha,  Jae-Kook

J Korean Dent Assoc > Volume 58(6); 2020 > Article

The Journal of The Korean Dental Association 2020;58(6):336-345.
Published online June 30, 2020.

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

Kwan-Joo Lee¹, Young Woo Song², Ui-Won Jung³, Jae-Kook Cha⁴

¹Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry
²Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry
³Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry
⁴Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry

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.

Key Words: bone regeneration;case report;dental implant;periapical lesion;peri-implantitis;