Peri‐Implant Cystic Lesion With Unusual Cellular Changes: A Case Report

Abstract

Introduction: This report describes the history and management of a cyst developing in anatomic contact with an immediately placed dental implant. Case Presentation: The lesion presented clinically as a facial swelling of the gingiva adjacent to an osseointegrated and restored maxillary right lateral incisor implant. Radiographs showed a well‐circumscribed radiolucency, which was contiguous with the implant surface. After reflection of a mucoperiosteal flap, the lesion was enucleated in toto, and the defect was curetted. The bony defect was grafted, and the lesional tissues were sent for histologic analysis. The results demonstrated the presence of a cyst of unknown origin with some unusual cellular changes in localized areas of the cyst lining resembling ameloblasts. Healing occurred uneventfully, and the patient was monitored for recurrence. At the 2‐year follow‐up appointment, the patient presented no clinical or radiographic signs of recurrence of the lesion. The etiology of this lesion is unknown. Conclusion: This case emphasizes the need for histologic diagnosis of peri‐implantitis lesions and suggests a need for expansion of the current classification system for peri‐implantitis lesions.

Peri‐implant epidermoid cyst: A case report and literature analysis

“…This lack of information may contribute to a limited understanding of peri‐implant diseases among clinicians and researchers. Through Web of Science, Embase, Pubmed, CNKI, and Wanfang database, the literature on “peri‐implant cysts” was searched since 2000, and we found that the related literature was extremely sparse 2,14–26 . All 13 retrieved articles were case reports, and together they included 16 cases with a total of 20 dental implants.…”

“…Regarding the origins of peri‐implant cysts, studies have found that peri‐implant cysts can result from pulpal necrosis of adjacent teeth, 23,25,26 dental implant inflammation, 2,14,15 and maxillary sinus mucosa and epithelial surplus 16,18,20–22,24 . In terms of clinical manifestations, among the 13 reports found in the literature, the clinical symptoms of peri‐implant cysts included mucosal swelling, 15,16,21,23,25 pain, 15,20 fistula 25 in the local mucosa of the implant periapical area, implant mobility, 22,26 and restoration mobility, 19 while some cases had no clinical symptoms 2,14,18,24 .…”

“…The previous literature suggests that the treatment goals for peri‐implant cysts include lesion clearance, reestablishing bone integration, and retaining the implant 2,14–26 . Lesion clearance involves removing adjacent tissue lesions 2,14–20,22–24,26 and peri‐implant cysts.…”

“…The previous literature suggests that the treatment goals for peri‐implant cysts include lesion clearance, reestablishing bone integration, and retaining the implant 2,14–26 . Lesion clearance involves removing adjacent tissue lesions 2,14–20,22–24,26 and peri‐implant cysts. Moreover, cyst recurrence is largely attributed to incomplete debridement during surgery, leading to the persistence of cystic tissues and subsequent cyst formation.…”

Calcifying Odontogenic Cyst Showing a Varied Epithelial Lining: An Additional Case with Implications for the Divergent Differentiation Capacity of the Cyst Epithelium

“…It has long been recognized that OCs frequently show the divergent differentiation and the various forms of metaplasia or prosoplasia [2][3][4]. A complex combination of two or more architectural or cellular peculiarities within one cyst suggests that with a subsequent interval of dormancy, the postembryonic odontogenic epithelium can proliferate at any time to form ameloblastic [20,21], squamous, keratotic, ghost, ciliated/mucous and sebaceous cells in pathologic states [2][3][4]. In purely pragmatic terms, the existence of "composite" OCs underscores the limitations of diagnosis based on small (marsupialized) biopsies.…”