Journal of Oral Implantology June 2014 - (Page 313)

CASE REPORT Active Implant Peri-Apical Lesion: A Case Report Treated Via Guided Bone Regeneration With a 5-Year Clinical and Radiographic Follow-Up Alessandro Quaranta, DDS, PhD1* Sebastiano Andreana, DDS, MS2 Giorgio Pompa, MD, DDS3 Maurizio Procaccini, MD, DDS4 Implant peri-apical lesion (IPL) is a periapical lesion, usually asymptomatic, in which the coronal portion of the implant achieves a normal bone to implant interface. A case of IPL following immediate implant placement and treated with guided bone regeneration (GBR) principles is described. Five-year clinical and radiographic followup with cone-beam assessment showed complete healing of the bone. GBR principles applied to IPL could completely solve the lesion. Key Words: dental implant, implant peri-apical lesion, retrograde peri-implantitis, GBR INTRODUCTION I mplant peri-apical lesion (IPL) or retrograde peri-implantitis is defined as a rapid infective, clinically asymptomatic periapical lesion radiographically diagnosed as a radiolucency in which the coronal portion of the implant achieves a normal bone to implant interface.1 This condition was first described by McAllister et al2 who suggested that microbial involvement from the implant site, the extracted teeth or adjacent teeth, generation of excess bone heat during implant placement and premature loading from inadequate relief of interim prostheses are probable causes for the development of such condition. It has been 1 ` School of Dentistry, Universita Politecnica delle Marche, Ancona, Italy; previously with Department of Prosthodontics and Implant Dentistry, University of Rome ''La Sapienza,'' Rome, Italy. 2 School of Dental Medicine, University at Buffalo, Buffalo, NY. 3 Department of Prosthodontics and Implant Dentistry, University of Rome ''La Sapienza,'' Rome, Italy. 4 ` School of Dentistry, Universita Politecnica delle Marche, Ancona, Italy. * Corresponding author, e-mail: s40ale@gmail.com DOI: 10.1563/AAID-JOI-D-11-00214 reported that maxillary premolars are usually more prone to periapical lesions.1,3 IPL usually develops shortly after implant placement and it is further classified into inactive (noninfected) or active (infected) condition, depending on the presence or absence of symptoms. Infected IPL has been linked to fistula formation, persistent local inflammation, and tenderness, whereas inactive IPL resembles a radiographic dense collagen apical scar.2 Information on the incidence as well as clinical decision-making guidelines regarding treatment of retrograde peri-implantitis are scarce in the literature, and mostly collected from clinical reports.2À7 In fact, several surgical treatment options have been proposed as different approaches for its treatment. In a study by Quirynen et al,3 among single implants placed at the university facilities those affected by retrograde peri-implantitis were diagnosed with radiographic evaluation and subsequently treated with a surgical approach. The implants under evaluation showed different surface features (machined or Ti-Unite) and were followed prospectively via intra-oral parallel techJournal of Oral Implantology 313

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

Controlled Early Inflammation and Bone Healing—Potential New Treatments
Zygomatic Implants: The Impact of Zygoma Bone Support on Biomechanics
A Comparative Study on Microgap of Premade Abutments and Abutments Cast in Base Metal Alloys
Topical Simvastatin Improves the Pro-Angiogenic and Pro-Osteogenic Properties of Bioglass Putty in the Rat Calvaria Critical-Size Model
Assessment of the Correlation Between Insertion Torque and Resonance Frequency Analysis of Implants Placed in Bone Tissue of Different Densities
Benefits of Rehabilitation With Implants in Masticatory Function: Is Patient Perception of Change in Accordance With the Real Improvement?
A Method for Fabrication of Implant-Supported Fixed Partial Dentures
Safe Sinus Lift: Use of Acrylic Stone Trimmer to Avoid Sinus Lining Perforation
The Effects of Sinus Membrane Pathology on Bone Augmentation and Procedural Outcome Using Minimal Invasive Antral Membrane Balloon Elevation
Cellular Responses to Metal Ions Released From Implants
A Two-Stage Surgical Approach to the Treatment of Severe Peri-Implant Defect: A 30-Month Clinical Follow-Up Report
Eight-Year Follow-Up of a Fixed-Detachable Maxillary Prosthesis Utilizing an Attachment System: Clinical Protocol for Individuals With Skeletal Class III Malocclusions
Active Implant Peri-Apical Lesion: A Case Report Treated Via Guided Bone Regeneration With a 5-year Clinical and Radiographic Follow-up
Flapless Implant Placement: A Case Report
Active Implant Periapical Lesions Leading to Implant Failure: Two Case Reports
A Review of Platelet Derived Growth Factor Playing Pivotal Role in Bone Regeneration
LETTER TO THE EDITOR
REVIEW OF CURRENT LITERATURE

Journal of Oral Implantology June 2014