The Management of Retrograde Peri-Implantitis: A Case Report

Mohamed, Jumshad B; Alam, Nazish; Singh, Gurudeep; Chandrasekaran, SC

doi:10.7860/jcdr/2012/4168.2575

Cited by 12 publications

(20 citation statements)

References 7 publications

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“…Presentation of fistula and radiographic lesion at implant apex was observed in 15 of 20 studies 20,24,28‐33,35,36,38,41‐44 . Four of 20 studies reported that only radiographic evidence of lesion was apparent, with no clinical signs of infection or inflammation 27,34,39,45 . In a case series of six patients, in which lesion had quicker onset compared with other case reports, clinical presentation was buccal or facial abscess with intense pain 33 …”

Section: Resultsmentioning

confidence: 98%

“…On the basis of case reports analyzed, RPI was diagnosed between 1 week and 4 years after implant placement 26 , 28 . Thirteen studies reported that RPI lesions were diagnosed within 6 months after implant placement 20,24,27‐44 . Predominant diagnostic presentation of lesion was presence of fistula at buccal or facial abscess of apical portion of implant, and subsequent periapical radiographs taken demonstrated radiolucent lesion.…”

Section: Resultsmentioning

confidence: 99%

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A Novel Treatment Decision Tree and Literature Review of Retrograde Peri‐Implantitis

Sarmast¹,

Wang

Σολδάτος³

et al. 2016

Journal of Periodontology

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Background: Although retrograde peri‐implantitis (RPI) is not a common sequela of dental implant surgery, its prevalence has been reported in the literature to be 0.26%. Incidence of RPI is reported to increase to 7.8% when teeth adjacent to the implant site have a previous history of root canal therapy, and it is correlated with distance between implant and adjacent tooth and/or with time from endodontic treatment of adjacent tooth to implant placement. Minimum 2 mm space between implant and adjacent tooth is needed to decrease incidence of apical RPI, with minimum 4 weeks between completion of endodontic treatment and actual implant placement. The purpose of this study is to compile all available treatment modalities and to provide a decision tree as a general guide for clinicians to aid in diagnosis and treatment of RPI. Methods: Literature search was performed for articles published in English on the topic of RPI. Articles selected were case reports with study populations ranging from 1 to 32 patients. Any case report or clinical trial that attempted to treat or rescue an implant diagnosed with RPI was included. Results: Predominant diagnostic presentation of a lesion was presence of sinus tract at buccal or facial abscess of apical portion of implant, and subsequent periapical radiographs taken demonstrated a radiolucent lesion. On the basis of case reports analyzed, RPI was diagnosed between 1 week and 4 years after implant placement. Twelve of 20 studies reported that RPI lesions were diagnosed within 6 months after implant placement. A step‐by‐step decision tree is provided to allow clinicians to triage and properly manage cases of RPI on the basis of recommendations and successful treatments provided in analyzed case reports. It is divided between symptomatic and asymptomatic implants and adjacent teeth with vital and necrotic pulps. Conclusions: Most common etiology of apical RPI is endodontic infection from neighboring teeth, which was diagnosed within 6 months after implant placement. Most common findings, radiographically and clinically, are lesions around implant apex and sinus tract. A small number of implants did not improve with treatment. Decision tree provides a path to diagnose and treat lesions to facilitate their management. Further studies are needed to focus on histologic data around periapical microbiota to establish specific etiology and differential diagnoses compared with marginal peri‐implantitis and other implant‐related conditions.

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Section: Resultsmentioning

confidence: 98%

Section: Resultsmentioning

confidence: 99%

A Novel Treatment Decision Tree and Literature Review of Retrograde Peri‐Implantitis

Sarmast¹,

Wang

Σολδάτος³

et al. 2016

Journal of Periodontology

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“…13,14,18,19,21 The prognosis can be considered fair to good. The resolution frequency of class III lesions is lower than that of class I and II lesions.…”

Section: Discussionmentioning

confidence: 99%

“…When the lesions belonged to class III at the time of diagnosis, the management is frequently more aggressive including open-flap debridement, bone graft, and barrier membrane placement and/or resection of the apical part of the implant. 7,13,14,18,51 If the lesion does not resolve or the implant is clinically mobile, the implant has to be explanted. 36,42,54,55 There are also reports of successful implant placement after explantation at the same site.…”

Section: Discussionmentioning

confidence: 99%

A Radiographic Classification for Retrograde Peri-implantitis

Shah¹,

Thomas²,

Kumar³

et al. 2016

The Journal of Contemporary Dental Practice

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Background: Retrograde peri-implantitis (RPI) is an inflammatory disease that affects the apical part of an osseointegrated implant, while the coronal portion of the implant sustains a normal bone-to-implant interface. It is a diagnostic and therapeutic dilemma for implantologists. There is lack of a standard classification system and a definite treatment algorithm for the same. This article aims to introduce a classification system for RPI based on the radiographic amount of bone loss around an implant apex. Materials and methods:A search of PubMed database was conducted with the keywords "retrograde peri-implantitis" and "implant periapical lesion." Preoperative intraoral periapical (IOPA) radiographs of implants with RPI in case reports/case series were compiled. A total of 54 IOPAs from 36 articles were compiled and were assessed.Results: Three different classes were proposed. The amount of bone loss from the apex of the implant to the most coronal part of radiolucency was calculated as a percentage of the total implant length and classified into one of the three classes: Mild, moderate, and advanced. Treatment options and prognosis have been suggested for each class. Conclusion:The proposed classification may allow for an easy and reproducible radiographic assessment of the RPI lesion and may serve as a guideline to prognosis and treatment planning.

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“…Se ha sugerido que el origen de esta lesión es a partir de microorganismos presentes en el alveolo durante la cicatrización o bien por lesiones periapicales en dientes adyacentes, de igual forma se ha sugerido que los microorganismos pueden reactivarse en el procedimiento quirúrgico durante la colocación del implante (Mohamed et al, 2012), por lo que se hace obligatorio el realizar un examen clínico minucioso que lleve a detectar los futuros focos de infección y así evitar el desarrollo de la periimplantitis retrograda o apical.…”

Section: Introduccionunclassified

Periimplantitis: Revisión de la Literatura

García-Calderón¹,

Cornejo²,

Cuevas-González

et al. 2016

Int. J. Odontostomat.

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GARCÍA-CALDERÓN, A. G.; DONOHUE-CORNEJO, A.; CUEVAS-GONZÁLEZ, M. V.; ÁVILA-VALDÉZ, R. & CUEVAS-GONZÁLEZ, J. C. Periimplantitis: revisión de la literatura. Int. J. Odontostomat., 10(2):255-260, 2016. RESUMEN:El uso de implantes ha tomado un gran auge en los últimos años, sin embargo así como se ha visto un aumento en la demanda también se ha visto un incremento en el fracaso de los mismos, existen múltiples razones que intervienen para esto como son; deficiencias en la cantidad y calidad de hueso, patologías óseas preexistentes, mala técnica quirúrgica, implante inadecuado, hábito tabáquico, entre otras. La mucositis periimplantaria y la periimplantitis son las primeras causas de complicaciones en los implantes, los pacientes con enfermedades crónico degenerativas, fumadores y con mala higiene son considerados pacientes de riesgo para presentar periimplantitis. La literatura ofrece tratamientos quirúrgicos y no quirúrgicos los cuales van enfocados a la eliminación de microorganismos y a la desinfección de la superficie del implante, el tratamiento quirúrgico como la debridación y curetaje tienen la finalidad de eliminar la placa bacteriana, desinfectar la superficie del implante así como retirar el tejido dañado por el proceso inflamatorio, el realizar una adecuada historia clínica y valoración previa, permitirá identificar a los pacientes con mayor o menor riesgo de desarrollar periimplantitis, las citas de mantenimiento ayudan a detectar oportunamente posibles complicaciones.PALABRAS CLAVE: periimplantitis; mucositis periimplantaria; enfermedad periodontal. INTRODUCCIONEl uso de implantes ha tomado un gran auge en los últimos años, sin embargo así como se ha visto un aumento en la demanda también se ha visto un incremento en el fracaso de los mismos, existen múltiples razones que intervienen para esto como son; deficiencias en la cantidad y calidad de hueso, patologías óseas preexistentes, mala técnica quirúrgica, implante inadecuado, hábito tabáquico, entre otras, sin embargo a pesar de controlar en medida de lo posible los factores antes mencionados, se llega a presentar el fracaso en el sitio de colocación del implante, dentro de las principales causas se encuentra la periimplantitis, la cual en términos clínicos se define como un proceso inflamatorio que afecta la función fisiológica del tejido duro y blando que se encuentra alrededor de un implante osteointegrado, o en vías de la osteointegración (McCrea, 2014) (Fig. 1) y la mucositis periimplantaria, en donde se aprecia una inflamación reversible del tejido circundante al implante, sin que haya perdida de tejido óseo.La prevalencia que se conoce sobre el desarrollo de la periimplantitis es muy variada, Schmidlin et al. (2012) realizaron un estudio transversal dirigido a odontólogos en donde determinaron una prevalencia que entre del 5-6 % y 7-9 % posterior a 5 y 10 años *

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The Management of Retrograde Peri-Implantitis: A Case Report

Cited by 12 publications

References 7 publications

A Novel Treatment Decision Tree and Literature Review of Retrograde Peri‐Implantitis

A Novel Treatment Decision Tree and Literature Review of Retrograde Peri‐Implantitis

A Radiographic Classification for Retrograde Peri-implantitis

Periimplantitis: Revisión de la Literatura

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