Inflammatory implant periapical lesion prior to osseointegration: A case series study

Purpose: To report 20 cases with implant periapical pathology diagnosed during the osseointegration phase,evaluating retrospectively the efficacy of the treatment with implant periapical surgery. Materials and Methods:A retrospective chart review was conducted of all patients in whom implant periapical surgery was performedbetween 1996 and 2010. The criteria for diagnosing implant periapical pathology and, accordingly, performingimplant periapical surgery were: (1) acute pain during the osseointegration period (8 weeks after implantplacement) located in the area of the affected implant or presence of mucous fistula in relation with the implantapex; (2) absence of implant mobility; (3) non-dull percussion of nonsubmerged implants; and (4) presenceor absence of implant periapical radiolucency. Results: Twenty-two implants were diagnosed with periapicalpathology in 20 patients (13 women and 7 men) with a mean age of 54.3 years (range, 32 to 70 years) and wereconsecutively treated by a surgical approach. In 19 implants, the diagnosis was acute apical peri-implantitis(nonsuppurated in 7 cases and suppurated in 12), as based on the symptoms and radiographic sign, and in 3cases it was subacute apical peri-implantitis, as based on the presence of a fistula. After a minimum follow-upof 1 year, 20 implants remained functional, with no clinical or radiologic alterations; the survival rate of thetreated implants was 91%. Conclusion: The early diagnosis of inflammatory implant periapical lesions duringthe osseintegration phase, and their prompt surgical treatment, led to a survival rate of the treated implants of91%.