Journal of Oral Implantology April 2014 - (Page 189)

CASE REPORT Nasopalatine Duct Cyst, a Delayed Complication to Successful Dental Implant Placement: Diagnosis and Surgical Management Shane Joseph McCrea, MMedSci, MSc The dental literature reports frequently on both the success and survival of dental implants, whereby the focus remains on the biological response of hard and soft tissue to the implants. The predication and anticipation of adverse implant events can then lead to the preemption of implant loss. However, biological situations can arise that are outside the control of the clinician. The author reports a case history of the late manifestation of a nasopalatine duct cyst in close proximity to a dental implant and its subsequent surgical management. Key Words: implantology, nasopalatine duct cyst, symphyseal graft INTRODUCTION T he use of dental implants for oral rehabilitation is now an accepted form of treatment. The dental literature reports frequently on both the success and survival of dental implants, whereby the focus remains on the biological response of hard and soft tissue to the implants: peri-implantitis, periapical implantitis, marginal bone level maintenance,1 increased pocket-probing depths, mucositis, suppuration, and attachment loss.2 The predication and anticipation of adverse implant events can then lead to the preemption of those events. However, biological situations can arise that are outside the control of the clinician. The author reports a case history of the late manifestation of a nasopalatine duct cyst (NPDC) in close proximity to a dental implant and its subsequent surgical management. The World Health Organization classifies the NPDC as a developmental, epithelial, nonodontogenic cystic lesion of the maxilla. The nasopalatine duct cyst is the most common nonodontogenic cyst of the oral cavity,3 occurring in about 1% of the British Society of Oral Implantology Southport, Merseyside, UK. * Corresponding author, e-mail: shanemccrea@aol.com DOI: 10.1563/AAID-JOI-D-12-00011 population.4 Radiographically, it can be mistaken for an apical lesion of endodontic origin. The cyst is believed to arise from the epithelial remnants of the nasopalatine duct, an embryological structure connecting the oral and nasal cavities in the area of the incisive canal.5 The cyst is unique, occurring in a single location, the midline of the anterior maxilla, developing at almost any age. However, the most common occurrence is in the fourth and sixth decades,4 with most studies showing a slight male predominance.6 The cysts are usually asymptomatic, being an incidental radiographic discovery. The most common reported clinical symptom is swelling of the anterior part of the palate in the vicinity of the incisal papilla and sometimes intermittent pain over a long period of time.7 If the cyst has caused resorption of the overlying bone, it is fluctuant and appears blue.8 Mucoid discharge may occur, causing patients to complain of a salty or foul taste. The more advanced cases can cause pain and itching.7,8 Radiographic findings Two-dimensional radiographs usually demonstrate a well-circumscribed round or oval radiolucency with a sclerotic border at or near the midline of the anterior maxilla, between and apical to the central Journal of Oral Implantology 189

Table of Contents for the Digital Edition of Journal of Oral Implantology April 2014

Consolidated Standards of Reporting Trials (CONSORT): Answering the Call for JOI’s Endorsement
Photoelastic Analysis of Stress Distribution With Different Implant Systems
Influence of Abutment Screw Design and Surface Coating on the Bending Flexural Strength of the Implant Set
Comparison of Implant-Abutment Interface Misfits After Casting and Soldering Procedures
Evaluation of Accuracy of Casts of Multiple Internal Connection Implant Prosthesis Obtained From Different Impression Materials and Techniques: An In Vitro Study
The Effect of Different Implant-Abutment Connections on Screw Joint Stability
Effects of pH and Elevated Glucose Levels on the Electrochemical Behavior of Dental Implants
Finite Element Analysis of Provisional Structures of Implant-Supported Complete Prostheses
Saliva Versus Peri-implant Inflammation: Quantification of IL-1b in Partially and Totally Edentulous Patients
Heat Generated During Seating of Dental Implant Fixtures
An Alternative Approach for Augmenting the Anterior Maxilla Using Autogenous Free Gingival Bone Graft for Implant Retained Prosthesis
Nasopalatine Duct Cyst, a Delayed Complication to Successful Dental Implant Placement: Diagnosis and Surgical Management
The Custom Endosteal Implant: Histology and Case Report of a Retrieved Maxillary Custom Osseous-Integrated Implant Nine Years in Service
Occlusal Concepts Application in Resolving Implant Prosthetic Failure: Case Report
Three-Year Follow-Up of a Single Immediate Implant Placed in an Infected Area: A New Approach for Harvesting Autogenous Symphysis Graft
Use of Stress Analysis Methods to Evaluate the Biomechanics of Oral Rehabilitation With Implants

Journal of Oral Implantology April 2014

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