Nonsurgical Endodontic Treatment of Necrotic Teeth Resolved Apical Lesions on Adjacent Implants with Retrograde/Apical Peri-implantitis: A Case Series with 2-year Follow-up

The Incidence of Retrograde Peri-Implantitis in a Single University Dental Hospital Training Center: A Retrospective Analysis

Background and objective: Retrograde peri-implantitis (RPI) is a periapical radiolucent lesion developed around the implant apex. This study aimed to investigate the Incidence of RPI in a single university dental hospital training center. Materials and Methods: All records of patients who received single Implants between 2016–2020 were screened. For cases that met inclusion criteria, clinical and radiographic data were analyzed. Results: A total of 215 were included and categorized as follows, Category A: implants were placed next to endodontically treated teeth (n = 58, 27%); category B, implants placed at the sites with previous endodontic involvement within 6 months of tooth extraction (n = 25, 11.6%); Category AB: implants placed at sites that fulfill the criteria of groups A and B (n = 18, 8.4%); and Category C: Implants that were placed next to vital teeth and at a site with no previous endodontic treatment or a site that was allowed to heal for more than six (n = 114, 53%). Categories A, B and AB served as the endodontically involved (EI) group, while category C served as non- endodontically involved (NEI) group. Only two sites (0.9%) were confirmed as RPI, both from group A (3.4%). Comparing all groups studied showed no statistically significant difference in RPI incidence. Conclusions: The incidence of RPI is low; however, endodontically treated teeth with periapical lesions (PALs) next to an implant site could contribute to RPI.

Successful Management of Peri-Implant Infection from the Endodontic Lesion of Adjacent Natural Tooth

Recently, dental implants have had the most important role in oral rehabilitation. Peri-implantitis is considered a common complication of dental implants. Adjacent natural teeth with untreated endodontic pathology may be a potential risk for implant placement. Retrograde/periapical peri-implantitis (RPI), the inverting of the progress direction of peri-implantitis. Radiographically, it is characterized by signs of periapical bone loss and normal coronal osteointegration of the implant; and its prevalence is closely associated with endodontic lesions of adjacent teeth. Another novel separate disease entity is known as the endodontic peri-implant defects (endo-implant defects), manifesting as the peri-implant marginal bone loss due to endodontic pathology of adjacent teeth, to which endodontists and implantologists are supposed to attach great importance. This current study presented two cases of different types of peri-implant infection in which conducting proper intervention to the endodontic lesions of adjacent teeth resulted in full radiographic and clinical resolution of peri-implant defects.

Implant Periapical Lesion: A Narrative Review

Implant periapical lesion (IPL) is an infectious-inflammatory alteration surrounding an implant apex. It is a multifactorial disease that may ultimately cause implant failure. The diagnosis of IPL is based on examination of clinical manifestations and apical radiolucency. Many etiologies have been attributed to IPL, including preexisting microbial pathology and surgical trauma. Moreover, many systems have been used to classify IPL based on different parameters. To date, non-surgical and surgical treatment, as well as removal of failed implants, have been considered to successfully manage IPL. However, prevention of IPL surpasses all modes of treatment. An increased number of IPL cases are expected as implants have become standard for tooth replacement in dentate arches. Therefore, it is necessary to understand IPL more comprehensively. Herein, an introduction to IPL, including its etiology, diagnosis, classification, treatment, and prevention, has been undertaken.

Correlation between endodontic pulpal/periapical disease and retrograde peri-implantitis: A case series

Retrograde peri-implantitis is a symptomatic complication, characterised by radiographic detection of bone loss at the periapex of the implant. The aim of this study was to investigate the possible endodontic aetiology, evaluating the effectiveness of surgical treatment without endodontic therapy of adjacent teeth. In the 10-year interval, three patients reported symptoms of retrograde peri-implantitis after a mean period of 30.6 days from implant placement. Mean follow-up after surgical procedures was 8.66 years, with an implant survival of 100%. Retrograde peri-implantitis was probably caused by colonisation of the apical surface of the implant by bacteria persisting in the area after endodontic failure/apical periodontitis, reactivated by drilling in the site. In all cases, the adjacent teeth remained vital during the years, showing that a direct cause-and-effect relationship between pulpal/periapical disease of adjacent teeth and retrograde peri-implantitis was never present.