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Implant Periapical Lesion: A Narrative Review. TECHNOLOGIES 2021. [DOI: 10.3390/technologies9030065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
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.
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Long term clinical result of implant induced injury on the adjacent tooth. Sci Rep 2021; 11:7913. [PMID: 33846470 PMCID: PMC8041840 DOI: 10.1038/s41598-021-87062-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2020] [Accepted: 03/23/2021] [Indexed: 11/08/2022] Open
Abstract
The purpose of the retrospective study was to investigate the long-term result of implant-induced injury on the adjacent tooth. The subjects of this retrospective study were patients who had received implants and had tooth injury; direct invasion of root (group I), root surface contact (group II), or < 1 mm distance of the implant from the root (group III). Clinical and pathological changes were periodically examined using radiographs and intra-oral examinations. Paired t-tests and chi-square tests were used to evaluate the implant stability quotient (ISQ) of implant and tooth complications, respectively (α = 0.05). A total of 32 implants and teeth in 28 patients were observed for average 122.7 (± 31.7, minimum 86) months. Seven teeth, three of which were subsequently extracted, needed root canal treatment. Finally, 90.6% of the injured teeth remained functional. Complications were significant and varied according to the group, with group I showing higher events than the others. The ISQs increased significantly. One implant in group I resulted in osseointegration failure. The implant survival rate was 96.9%. In conclusion, it was found even when a tooth is injured by an implant, immediate extraction is unnecessary, and the osseointegration of the invading implant is also predictable.
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Di Murro B, Canullo L, Pompa G, Di Murro C, Papi P. Prevalence and treatment of retrograde peri-implantitis: a retrospective cohort study covering a 20-year period. Clin Oral Investig 2021; 25:4553-4561. [PMID: 33443685 PMCID: PMC8310488 DOI: 10.1007/s00784-020-03769-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 12/28/2020] [Indexed: 12/23/2022]
Abstract
Objectives The aims of this retrospective study were to report data on the prevalence of retrograde peri-implantitis (RPI) in a single-center in a 20-year observation period and to evaluate implant survival after surgical treatment. Materials and methods A retrospective cohort study was conducted screening all patients who underwent implant treatment in a private practice. Patients were enrolled if they had one or more implants showing a radiolucency around the implant apex, without implant mobility. Furthermore, clinical symptoms of RPI and days from symptoms’ appearance after implant placement were also collected, as well as periodontal and endodontic status of nearby teeth. All patients were treated with the same surgical approach: antibiotic therapy, mechanical curettage, chemical decontamination and xenograft application. Results Out of the 1749 implants placed, only 6 implants were classified as affected by RPI, with a prevalence of 0.34%. Clinical symptoms of RPI (pain, swelling, dull percussion or fistula presence) varied among patients and were reported after a mean period of 51.83 ± 52.43 days. Conclusions RPI was successfully treated with surgical curettage and bone substitute application and all implants are still in place after a mean follow-up of 8.83 ± 5.34 years. Clinical relevance Bacteria from teeth with failed endodontic treatment or residual lesions might be reactivated by drilling for implant osteotomy, with subsequent colonization of the implant apex and possible failure before prosthetic loading. Therefore, it might be recommended to take a periapical x-ray at implant placement and after 6–8 weeks in order to intercept RPI before prostheses delivery.
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Affiliation(s)
- Bianca Di Murro
- Oral Surgery Unit, Department of Oral and Maxillo-Facial Sciences, 'Sapienza' University of Rome, Via Caserta 6, 00161, Rome, Italy
| | | | - Giorgio Pompa
- Oral Surgery Unit, Department of Oral and Maxillo-Facial Sciences, 'Sapienza' University of Rome, Via Caserta 6, 00161, Rome, Italy
| | | | - Piero Papi
- Oral Surgery Unit, Department of Oral and Maxillo-Facial Sciences, 'Sapienza' University of Rome, Via Caserta 6, 00161, Rome, Italy.
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Di Murro B, Papi P, Di Murro C, Pompa G, Gambarini G. Correlation between endodontic pulpal/periapical disease and retrograde peri-implantitis: A case series. AUST ENDOD J 2020; 47:358-364. [PMID: 33159493 DOI: 10.1111/aej.12458] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Revised: 09/26/2020] [Accepted: 10/21/2020] [Indexed: 12/30/2022]
Abstract
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.
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Affiliation(s)
- Bianca Di Murro
- Oral Surgery Unit, Department of Oral and Maxillo-Facial Sciences, 'Sapienza' University of Rome, Rome, Italy
| | - Piero Papi
- Oral Surgery Unit, Department of Oral and Maxillo-Facial Sciences, 'Sapienza' University of Rome, Rome, Italy
| | | | - Giorgio Pompa
- Oral Surgery Unit, Department of Oral and Maxillo-Facial Sciences, 'Sapienza' University of Rome, Rome, Italy
| | - Gianluca Gambarini
- Endodontic Unit, Department of Oral and Maxillofacial Sciences, 'Sapienza' University of Rome, Rome, Italy
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Sisli SN, Pektas ZO. What Is the Role of Endodontic Predisposing Factors in Early Implant Failure? J ORAL IMPLANTOL 2020; 46:491-495. [PMID: 32315422 DOI: 10.1563/aaid-joi-d-19-00141] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
We aimed to investigate a possible relationship between early implant failure (EIF) and an adjacent root canal-treated tooth and/or tooth with a periapical lesion (PL), considering the duration between implantation and root canal treatment (RCT). The importance of prior RCT and/or presence of a PL before implantation was also investigated. A total of 810 implants from 342 patients were included and scored according to the implant failure before abutment connection, adjacent root canal treated teeth, adjacent teeth without RCT, no adjacent teeth, adjacent teeth with PL, extraction of teeth with PL, and/or RCT before implantation. The durations between the extraction and implantation and between RCT and implantation adjacent to the root canal-treated teeth were recorded. The time from the RCT of adjacent teeth to implant placement was categorized into 5 groups: less than 4 weeks before implantation, 4-12 weeks before implantation, at least 12 weeks before implantation, within 4 weeks after implantation, and at least 4 weeks after implantation. Among the endodontic predictors, a prior PL on the tooth extracted was associated with an increased risk of EIF (P < .05, odds ratio: 4.37; 95% confidence interval: 1.604-11.891). Furthermore, EIF was more likely to occur when the RCT of an adjacent tooth was performed within 4 weeks of implantation (P < .05). Additional investigations with larger sample sizes are necessary to validate our findings.
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Affiliation(s)
- Selen Nihal Sisli
- Baskent University Faculty of Dentistry, Department of Endodontics, Ankara, Turkey
| | - Zafer Ozgur Pektas
- Private Clinic, Department of Oral and Maxillofacial Surgery, Adana, Turkey
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Schwarz F, Derks J, Monje A, Wang HL. Peri-implantitis. J Periodontol 2019; 89 Suppl 1:S267-S290. [PMID: 29926957 DOI: 10.1002/jper.16-0350] [Citation(s) in RCA: 402] [Impact Index Per Article: 80.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2016] [Revised: 09/14/2017] [Accepted: 09/24/2017] [Indexed: 12/28/2022]
Abstract
OBJECTIVES This narrative review provides an evidence-based overview on peri-implantitis for the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions. METHODS A literature review was conducted addressing the following topics: 1) definition of peri-implantitis; 2) conversion from peri-implant mucositis to peri-implantitis, 3) onset and pattern of disease progression, 4) characteristics of peri-implantitis, 5) risk factors/indicators for peri-implantitis, and 6) progressive crestal bone loss in the absence of soft tissue inflammation. CONCLUSIONS 1)Peri-implantitis is a pathological condition occurring in tissues around dental implants, characterized by inflammation in the peri-implant connective tissue and progressive loss of supporting bone. 2)The histopathologic and clinical conditions leading to the conversion from peri-implant mucositis to peri-implantitis are not completely understood. 3)The onset of peri-implantitis may occur early during follow-up and the disease progresses in a non-linear and accelerating pattern. 4a)Peri-implantitis sites exhibit clinical signs of inflammation and increased probing depths compared to baseline measurements. 4b)At the histologic level, compared to periodontitis sites, peri-implantitis sites often have larger inflammatory lesions. 4c)Surgical entry at peri-implantitis sites often reveals a circumferential pattern of bone loss. 5a)There is strong evidence that there is an increased risk of developing peri-implantitis in patients who have a history of chronic periodontitis, poor plaque control skills, and no regular maintenance care after implant therapy. Data identifying "smoking" and "diabetes" as potential risk factors/indicators for peri-implantitis are inconclusive. 5b)There is some limited evidence linking peri-implantitis to other factors such as: post-restorative presence of submucosal cement, lack of peri-implant keratinized mucosa and positioning of implants that make it difficult to perform oral hygiene and maintenance. 6)Evidence suggests that progressive crestal bone loss around implants in the absence of clinical signs of soft tissue inflammation is a rare event.
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Affiliation(s)
- Frank Schwarz
- Department of Oral Surgery and Implantology, Carolinum, Johann Wolfgang Goethe-University Frankfurt, Frankfurt, Germany
| | - Jan Derks
- Department of Periodontology, Institute of Odontology, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Alberto Monje
- Department of Oral Surgery and Stomatology, ZMK School of Dentistry, University of Bern, Bern, Switzerland.,Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA
| | - Hom-Lay Wang
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA
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Abstract
Bone augmentation is an extremely common procedure in implant dentistry today because of significant advancements with reactive biomaterials, a better understanding of the mechanism of action that is found with growth factors contained in platelets, and improvements in surgical techniques. The expectation is for the surgeon to place the dental implant in the position that best serves the requirements of the prosthetic restorations. With the increasing demands that patients have for ideal prosthetic results, surgeons are expected to predictably augment both hard and soft tissues to provide the anticipated esthetic and functional outcomes. Bone grafting can be performed before, during, and after the implant placement; however, these augmentation procedures come with increased cost, the risk of complications such as infection or failure, and lengthening of the total treatment time. In addition, a plethora of grafting materials are available commercially, where they are often inadequately studied, or there is minimal information regarding their predictability or long-term success, or ability to support dental implants. It is clear that although the surgical field has seen major progress since early implant surgical techniques in the 1980s, major challenges still exist with hard tissue augmentation procedures. This review will discuss these challenges that are increased and often specific to bone graft healing, and which are becoming more common as implant site development often requires bone augmentation to improve volume or contour deficiencies. The risk factors that patients may present with that will affect outcomes with bone augmentation procedures are identified, and recommendations for the prevention of complications or managing complications once they have occurred are provided.
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Affiliation(s)
- Peter K Moy
- Department of Oral & Maxillofacial Surgery, UCLA, School of Dentistry, Los Angeles, California, USA
| | - Tara Aghaloo
- Department of Oral & Maxillofacial Surgery, UCLA, School of Dentistry, Los Angeles, California, USA
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Schwarz F, Derks J, Monje A, Wang HL. Peri-implantitis. J Clin Periodontol 2019; 45 Suppl 20:S246-S266. [PMID: 29926484 DOI: 10.1111/jcpe.12954] [Citation(s) in RCA: 384] [Impact Index Per Article: 76.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2016] [Revised: 09/14/2017] [Accepted: 09/24/2017] [Indexed: 01/14/2023]
Abstract
OBJECTIVES This narrative review provides an evidence-based overview on peri-implantitis for the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions. METHODS A literature review was conducted addressing the following topics: 1) definition of peri-implantitis; 2) conversion from peri-implant mucositis to peri-implantitis, 3) onset and pattern of disease progression, 4) characteristics of peri-implantitis, 5) risk factors/indicators for peri-implantitis, and 6) progressive crestal bone loss in the absence of soft tissue inflammation. CONCLUSIONS 1)Peri-implantitis is a pathological condition occurring in tissues around dental implants, characterized by inflammation in the peri-implant connective tissue and progressive loss of supporting bone. 2)The histopathologic and clinical conditions leading to the conversion from peri-implant mucositis to peri-implantitis are not completely understood. 3)The onset of peri-implantitis may occur early during follow-up and the disease progresses in a non-linear and accelerating pattern. 4a)Peri-implantitis sites exhibit clinical signs of inflammation and increased probing depths compared to baseline measurements. 4b)At the histologic level, compared to periodontitis sites, peri-implantitis sites often have larger inflammatory lesions. 4c)Surgical entry at peri-implantitis sites often reveals a circumferential pattern of bone loss. 5a)There is strong evidence that there is an increased risk of developing peri-implantitis in patients who have a history of chronic periodontitis, poor plaque control skills, and no regular maintenance care after implant therapy. Data identifying "smoking" and "diabetes" as potential risk factors/indicators for peri-implantitis are inconclusive. 5b)There is some limited evidence linking peri-implantitis to other factors such as: post-restorative presence of submucosal cement, lack of peri-implant keratinized mucosa and positioning of implants that make it difficult to perform oral hygiene and maintenance. 6)Evidence suggests that progressive crestal bone loss around implants in the absence of clinical signs of soft tissue inflammation is a rare event.
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Affiliation(s)
- Frank Schwarz
- Department of Oral Surgery and Implantology, Carolinum, Johann Wolfgang Goethe-University Frankfurt, Frankfurt, Germany
| | - Jan Derks
- Department of Periodontology, Institute of Odontology, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Alberto Monje
- Department of Oral Surgery and Stomatology, ZMK School of Dentistry, University of Bern, Bern, Switzerland.,Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA
| | - Hom-Lay Wang
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA
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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. J Endod 2019; 45:645-650. [DOI: 10.1016/j.joen.2019.01.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Revised: 12/18/2018] [Accepted: 01/03/2019] [Indexed: 11/21/2022]
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Management of Retrograde Peri-Implantitis Using an Air-Abrasive Device, Er,Cr:YSGG Laser, and Guided Bone Regeneration. Case Rep Dent 2018; 2018:7283240. [PMID: 29850281 PMCID: PMC5925184 DOI: 10.1155/2018/7283240] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Accepted: 03/19/2018] [Indexed: 12/30/2022] Open
Abstract
Background The placement of an implant in a previously infected site is an important etiologic factor contributing to implant failure. The aim of this case report is to present the management of retrograde peri-implantitis (RPI) in a first maxillary molar site, 2 years after the implant placement. The RPI was treated using an air-abrasive device, Er,Cr:YSGG laser, and guided bone regeneration (GBR). Case Description A 65-year-old Caucasian male presented with a draining fistula associated with an implant at tooth #3. Tooth #3 revealed periapical radiolucency two years before the implant placement. Tooth #3 was extracted, and a ridge preservation procedure was performed followed by implant rehabilitation. A periapical radiograph (PA) showed lack of bone density around the implant apex. The site was decontaminated with an air-abrasive device and Er,Cr:YSGG laser, and GBR was performed. The patient was seen every two weeks until suture removal, followed by monthly visits for 12 months. The periapical X-rays, from 6 to 13 months postoperatively, showed increased bone density around the implant apex, with no signs of residual clinical or radiographic pathology and probing depths ≤4 mm. Conclusions The etiology of RPI in this case was the placement of an implant in a previously infected site. The use of an air-abrasive device, Er,Cr:YSGG, and GBR was utilized to treat this case of RPI. The site was monitored for 13 months, and increased radiographic bone density was noted.
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Blaya-Tárraga JA, Cervera-Ballester J, Peñarrocha-Oltra D, Peñarrocha-Diago M. Periapical implant lesion: A systematic review. Med Oral Patol Oral Cir Bucal 2017; 22:e737-e749. [PMID: 29053646 PMCID: PMC5813993 DOI: 10.4317/medoral.21698] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2016] [Accepted: 05/26/2017] [Indexed: 11/11/2022] Open
Abstract
Background The aim of this study was to systematically review the evidence for periapical implant lesion, which makes a patient more susceptible to the periapical lesion, frequency, symptoms, signs (including radiological findings) and possible treatment options. Material and Methods A systematic literature review and analysis of publications included in PubMed, Embase and Cochrane; articles published until March 2016; with a populations, exposures and outcomes (PEO) search strategy was performed, focused on the issue: “In patients with periapical lesion to the implant during the osseointegration, what symptoms, signs, and changes in complementary examination manifested, for according to that stage, be intervened with the appropriate approach?”. The set criteria for inclusion were peer-reviewed articles. Results From a total of 212 papers identified, 36 studies were included in this systematic review, with 15461 implants evaluated and 183 periapical implant lesions. Which 8 papers included more than 5 cases and 28 included equal or less than 5 cases. Analysis of the papers revealed that periapical implant lesion is classified according to evolution stages into acute (non-suppurated and suppurated) and subacute (or suppurated-fistulized). In the acute stage and in the subacute if there is no loss of implant stability, the correct treatment approach is implant periapical surgery. In the subacute stage associated with implant mobility the implant must be removed. Conclusions Evidence on the subject is very limited, there are few studies with small sample, without homogeneity of criteria for diagnosing the disease and without design of scientific evidence. Currently etiology lacks consensus. The early diagnosis of periapical implant periapical lesions during the osseointegration phase and early treatment, will lead to a higher survival rate of implants treated, hence preventing the need for implant extraction. Key words:Apical peri-implantitis, retrograde peri-implantitis, inflammatory peri-implantitis lesion.
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Affiliation(s)
- J-A Blaya-Tárraga
- Unidad de Cirugía Bucal, Facultat de Medicina i Odontologìa, Universitat de València, C/ Gascó Oliag 1, 46010 Valencia, Spain,
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Sarmast ND, Wang HH, Soldatos NK, Angelov N, Dorn S, Yukna R, Iacono VJ. A Novel Treatment Decision Tree and Literature Review of Retrograde Peri-Implantitis. J Periodontol 2016; 87:1458-1467. [DOI: 10.1902/jop.2016.160219] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Abstract
PURPOSE To discuss the terminology, etiopathogenesis, and treatment of radiolucent inflammatory implant periapical lesions. MATERIALS AND METHODS An electronic search for relevant articles published in the English literature in the PubMed database. RESULTS Bacterial contamination of the apical portion of the implant either from a preexisting dental periapical infection or from a periapical lesion of endodontic origin of an adjacent tooth is the probable causative factor. Aseptic bone necrosis owing to overheating of the bone during preparation of osteotomies, or compression of the bone at the apex of the implant owing to excessive tightening, may also play a role. The histopathological features are of a mixed inflammatory cell infiltrate on a background of granulation tissue consistent with either a granuloma or an abscess as may be found at the apex of a nonvital tooth. Treatment consists of immediate and aggressive surgical debridement, chemical detoxification of the apical portion of the exposed implant surface, and systemic antibiotics with or without a bone regenerative procedure. CONCLUSION A radiolucent inflammatory implant periapical lesion is analogous to either a granuloma or an abscess as may be found at the apex of a nonvital tooth.
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Assessment of Intraobserver and Interobserver Agreement of a New Classification System for Retrograde Periimplantitis. IMPLANT DENT 2016; 25:817-824. [PMID: 27540842 DOI: 10.1097/id.0000000000000470] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Retrograde periimplantitis (RPI) is the 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. The aim of the current study was to assess the intraexaminer and interexaminer reliability of a proposed new classification system for RPI. MATERIALS AND METHODS After thorough electronic literature search, 56 intraoral periapical radiographs (IOPA) of implants with RPI were collected and were classified by 2 independent reviewers as per the new classification system into one of the 3-mild, moderate, and advanced-classes based on the amount of bone loss from the apex of the implant to the most coronal part as a percentage of the total implant length. The IOPAs were assessed twice by the same examiners and both were blinded to each other's observations. RESULTS The intraobserver agreement ranged from 0.85 to 0.91, which falls under the category of almost perfect agreement. The interexaminer agreement was found to be 0.83, also considered as almost perfect agreement. CONCLUSION The proposed classification shows good intraexaminer and interexaminer reliability and can be used for treatment planning and prognosis in cases of RPI.
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Sukumar S, Dřízhal I, Paulusová V, Bukač J. Surgical Treatment of Periodontal Intrabony Defects with Calcium Sulphate in Combination with Beta-Tricalcium Phosphate: Clinical Observations Two Years Post-Surgery. ACTA MEDICA (HRADEC KRÁLOVÉ) 2016. [DOI: 10.14712/18059694.2016.11] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The study was designed to evaluate the clinical outcome of a composite material, beta-tricalcium phosphate in combination with calcium sulphate, in the treatment of periodontal intrabony defects. The combination of these materials is believed to aid in guided tissue regeneration owing to their properties. A total of 47 teeth with intrabony defects in 26 periodontitis patients were treated with Fortoss® Vital (Biocomposites, Staffordshire, UK). Clinical parameters were evaluated which included changes in probing depth, clinical attachment level/loss and gingival recession at the baseline and 2 years postoperatively. The mean differences in measurements between the baseline and 2 years postoperatively were a reduction of 2.07±1.14 mm (p=0.000) in case of probing depth and a gain of 1.93±1.36 mm (p=0.000) in clinical attachment level; but an increase of 0.14±0.73 mm (p=0.571) in gingival recession. The study results show that the treatment with a combination of beta tricalcium phosphate and calcium sulphate led to a significantly favorable clinical improvement in periodontal intrabony defects 2 years after the surgery.
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Shah R, Thomas R, Kumar ABT, Mehta DS. A Radiographic Classification for Retrograde Peri-implantitis. J Contemp Dent Pract 2016; 17:313-21. [PMID: 27340166 DOI: 10.5005/jp-journals-10024-1847] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
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 lOPAs 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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Affiliation(s)
- Rucha Shah
- Lecturer, Department of Periodontics, Bapuji Dental College and Hospital, Davangere, Karnataka, India, Phone: +917676279879, e-mail:
| | - Raison Thomas
- Department of Periodontics, Bapuji Dental College and Hospital, Davangere, Karnataka, India
| | - A B Tarun Kumar
- Department of Periodontics, Bapuji Dental College and Hospital, Davangere, Karnataka, India
| | - Dhoom Singh Mehta
- Department of Periodontics, Bapuji Dental College and Hospital, Davangere, Karnataka, India
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Kutlu HB, Genc T, Tozum TF. Treatment of Refractory Apical Peri-Implantitis: A Case Report. J ORAL IMPLANTOL 2016; 42:104-9. [DOI: 10.1563/aaid-joi-d-13-00268] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Hüseyin Burak Kutlu
- Department of Periodontology, Faculty of Dentistry, Hacettepe University, Ankara, Turkey
| | - Tolga Genc
- Department of Periodontology, Faculty of Dentistry, Hacettepe University, Ankara, Turkey
| | - Tolga Fikret Tozum
- Department of Periodontics, College of Dentistry, University of Illinois at Chicago, Chicago, Ill
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ArunKumar KV, Deepa D. Migratory and misleading abscess of oro-facial region. J Indian Soc Periodontol 2015; 19:470-3. [PMID: 26392702 PMCID: PMC4555811 DOI: 10.4103/0972-124x.152408] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2014] [Accepted: 02/02/2015] [Indexed: 11/10/2022] Open
Abstract
Acute pericoronitis usually presents with severe localized pain, swelling and sometimes trismus. However, chronic pericoronitis and periodontal abscess produce a dull pain, moderate swelling and are occasionally seen migrating into distant sites producing fistulae intra-orally and/or extra-orally. This may quite often cause diagnostic dilemmas necessitating thorough medical and dental history, careful clinical examination and sometimes special investigations to confirm the etiology and or origin of infection. Here, we present three such cases and their management.
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Affiliation(s)
| | - Dhruvakumar Deepa
- Department of Periodontology, Subharti Dental College and Hospital, Meerut, Uttar Pradesh, India
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Al-Shamiri HM, Alaizari NA, Al-Maweri SA, Tarakji B. Development of pyogenic granuloma and hemangioma after placement of dental implants: A review of literature. J Int Soc Prev Community Dent 2015; 5:77-80. [PMID: 25992330 PMCID: PMC4415333 DOI: 10.4103/2231-0762.155725] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Aim: The aim of this study is to highlight the development of pyogenic granuloma and hemangioma after the placement of dental implants. Materials and Methods: A literature search was performed using MEDLINE, accessed via the National Library of Medicine PubMed Interface, for articles published between 2000 and 2014 in English, relating to the occurrence of pyogenic granuloma or hemangioma in relation to dental implants. Results: Our search identified only four case reports of pyogenic granuloma and hemangioma related to dental implants as reported in the English literature. Conclusion: Placement of dental implants can cause development of pyogenic granuloma and hemangioma, indicating that placement of dental implants requires well-trained specialists with perfect skills in dental implantology. Furthermore, the critical selection of the appropriate case is of paramount importance to avoid the occurrence of such complications.
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Affiliation(s)
| | - Nader Ahmed Alaizari
- Department of Oral and Maxillofacial Sciences, Al-Farabi Colleges, Riyadh, Saudi Arabia
| | - Sadeq Ali Al-Maweri
- Department of Oral and Maxillofacial Sciences, Al-Farabi Colleges, Riyadh, Saudi Arabia
| | - Bassel Tarakji
- Department of Oral and Maxillofacial Sciences, Al-Farabi Colleges, Riyadh, Saudi Arabia
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Kahler B. Healing of a Cyst-like Lesion Involving an Implant with Nonsurgical Management. J Endod 2015; 41:749-52. [DOI: 10.1016/j.joen.2014.12.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2014] [Revised: 12/16/2014] [Accepted: 12/16/2014] [Indexed: 11/27/2022]
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Kang YH, Byun JH, Choi MJ, Lee JS, Jang JH, Kim YI, Park BW. Co-development of pyogenic granuloma and capillary hemangioma on the alveolar ridge associated with a dental implant: a case report. J Med Case Rep 2014; 8:192. [PMID: 24934284 PMCID: PMC4082161 DOI: 10.1186/1752-1947-8-192] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2014] [Accepted: 04/01/2014] [Indexed: 11/10/2022] Open
Abstract
Introduction The development of various benign oral mucosal lesions associated with dental implants, such as pyogenic granuloma or peripheral giant cell granuloma, has been rarely reported. However, the occurrence of vascular diseases, such as hemangioma, related to dental implants has not been explored in the literature. In this study, we report a case of co-development of pyogenic granuloma and capillary hemangioma on the alveolar ridge associated with a dental implant in a patient undergoing antithrombotic therapy. To the best of our knowledge, this is first case of hemangioma formation associated with a dental implant. Case presentation A 68-year-old Korean man was referred for intermittent bleeding and a dome-shaped overgrowing mass on his upper alveolar ridge. He underwent dental implantation 5 years ago, and was started on warfarin for cerebral infarction a year ago. He had experienced gum bleeding and gingival mass formation 6 months after warfarinization; then, his implant fixture was removed. However, his gingival mass has been gradually increasing. The gingival mass was surgically excised, and revealed the coexistence of pyogenic granuloma and capillary hemangioma in histological analysis of the specimen. The lesion has showed no recurrence for more than a year. Conclusions Regarding immunostaining features, the endothelial cell markers, CD34 and CD31, and the mesenchymal cell marker, vimentin, were strongly detected, but cell proliferation marker, Ki-67, was negatively expressed in the endothelial cells of the hemangioma portion. However, in the pyogenic granuloma portion, CD34 was almost negatively detected, whereas vimentin and Ki-67 were highly detected in the fibroblast-like tumor cells. According to these heterogeneous characteristics of the lesion, the patient was diagnosed with coexistence of pyogenic granuloma and capillary hemangioma associated with the dental implant on the attached gingiva. We recommend that patients with dental implants who have chronic peri-implantitis under antithrombotic therapy should be closely followed to ensure early detection of oral mucosal abnormalities.
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Affiliation(s)
| | | | | | | | | | | | - Bong-Wook Park
- Department of Oral and Maxillofacial Surgery, Institute of Health Science, School of Medicine, Gyeongsang National University, Jinju, Korea.
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Buhara O, Uyanık LO, Ayalı A, Aydın M. Active implant periapical lesions leading to implant failure: two case reports. J ORAL IMPLANTOL 2014; 40:325-9. [PMID: 24914920 DOI: 10.1563/aaid-joi-d-11-00127] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Implant periapical lesion (IPL), an inflammatory lesion surrounding the apex of a dental implant, has been previously reported as a possible cause for implant failure. This article describes 2 successive cases of active IPL that were diagnosed early by clinical signs and radiologic findings. Lesions were treated surgically with implant removal and debridement. The etiology, findings, and treatment approaches for IPL are discussed in comparison with other reports.
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Affiliation(s)
- Oğuz Buhara
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Near East University, Nicosia, North Cyprus
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Mahmood R, Puthussery FJ, Flood T, Shekhar K. Dental implant complications - extra-oral cutaneous fistula. Br Dent J 2013; 215:69-70. [PMID: 23887526 DOI: 10.1038/sj.bdj.2013.683] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/08/2013] [Indexed: 11/09/2022]
Abstract
Dental implants have shown great success in recent years. However, in certain circumstances they can suffer from complications. It usually results from a combination of infection and host inflammatory responses or a lack thereof. This report documents an extra-oral cutaneous fistula associated with an osseointegrated dentoalveolar implant.
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Affiliation(s)
- R Mahmood
- Aintree University Hospital, Liverpool, L9 7AL, UK.
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Qu C, Meng H, Han J. Implant periapical lesion - a review and a case report with histological evaluation. Clin Oral Implants Res 2013; 25:1099-104. [PMID: 23845060 DOI: 10.1111/clr.12232] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/08/2013] [Indexed: 11/29/2022]
Affiliation(s)
- Chunna Qu
- Department of Periodontology; Peking University School and Hospital of Stomatology; Beijing China
| | - Huanxin Meng
- Department of Periodontology; Peking University School and Hospital of Stomatology; Beijing China
| | - Jie Han
- Department of Periodontology; Peking University School and Hospital of Stomatology; Beijing China
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Thompson-Sloan TN, Kolhatkar S, Bhola M. Management of Retrograde Peri-Implantitis by Apical Resection and Guided Bone Regeneration in Adjacent Maxillary Implants. Clin Adv Periodontics 2012. [DOI: 10.1902/cap.2012.110106] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Peñarrocha-Diago M, Maestre-Ferrín L, Cervera-Ballester J, Peñarrocha-Oltra D. Implant periapical lesion: diagnosis and treatment. Med Oral Patol Oral Cir Bucal 2012; 17:e1023-7. [PMID: 22926472 PMCID: PMC3505697 DOI: 10.4317/medoral.17996] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2011] [Accepted: 03/06/2012] [Indexed: 11/23/2022] Open
Abstract
The implant periapical lesion is the infectious-inflammatory process of the tissues surrounding the implant apex. It may be caused by different factors: contamination of the implant surface, overheating of bone during drilling, preparation of a longer implant bed than the implant itself, and pre-existing bone disease. Diagnosis is achieved by studying the presence of symptoms and signs such us pain, swelling, suppuration or fistula; in the radiograph an implant periapical radiolucency may appear.
A diagnostic classification is proposed to establish the stage of the lesion, and determine the best treatment option accordingly. The following stages are distinguished: acute apical periimplantitis (non-suppurated and suppurated) and subcacute (or suppurated-fistulized) apical periimplantitis. The most adequate treatment of this pathology in the acute stage and in the subacute stage if there is no loss of implant stability is apical surgery. In the subacute stage, if there is implant mobility, the extraction of the implant is necessary.
Key words:Implant periapical lesion, apical periimplantitis, retrograde periimplantitis.
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Hosseini M, Worsaae N, Schiødt M, Gotfredsen K. A 3-year prospective study of implant-supported, single-tooth restorations of all-ceramic and metal-ceramic materials in patients with tooth agenesis. Clin Oral Implants Res 2012; 24:1078-87. [DOI: 10.1111/j.1600-0501.2012.02514.x] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/03/2012] [Indexed: 11/28/2022]
Affiliation(s)
- Mandana Hosseini
- Department of Oral Rehabilitation, School of Dentistry, Faculty of Health Science; University of Copenhagen; Copenhagen; Denmark
| | - Nils Worsaae
- Department of Dental, Oral and Maxillofacial Surgery; Rigshospitalet; Copenhagen; Denmark
| | - Morten Schiødt
- Department of Dental, Oral and Maxillofacial Surgery; Rigshospitalet; Copenhagen; Denmark
| | - Klaus Gotfredsen
- Department of Oral Rehabilitation, School of Dentistry, Faculty of Health Science; University of Copenhagen; Copenhagen; Denmark
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Mohamed JB, Shivakumar B, Sudarsan S, Arun KV, Kumar TSS. Retrograde peri-implantitis. J Indian Soc Periodontol 2011; 14:57-65. [PMID: 20922082 PMCID: PMC2933532 DOI: 10.4103/0972-124x.65444] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Revised: 04/24/2009] [Accepted: 10/04/2009] [Indexed: 11/28/2022] Open
Abstract
Retrograde peri-implantitis constitutes an important cause for implant failure. Retrograde peri-implantitis may sometimes prove difficult to identify and hence institution of early treatment may not be possible. This paper presents a report of four cases of (the implant placed developing to) retrograde peri-implantitis. Three of these implants were successfully restored to their fully functional state while one was lost due to extensive damage. The paper highlights the importance of recognizing the etiopathogenic mechanisms, preoperative assessment, and a strong postoperative maintenance protocol to avoid retrograde peri-implant inflammation.
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Affiliation(s)
- Jumshad B Mohamed
- Department of Periodontology and Oral Implantology, Sree Balaji Dental College and Hospital, Uthandi, Chennai, India
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Chan HL, Wang HL, Bashutski JD, Edwards PC, Fu JH, Oh TJ. Retrograde Peri-Implantitis: A Case Report Introducing an Approach to Its Management. J Periodontol 2011; 82:1080-8. [DOI: 10.1902/jop.2010.100585] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Olmedo D, Paparella M, Brandizzi D, Cabrini R. Reactive lesions of peri-implant mucosa associated with titanium dental implants: a report of 2 cases. Int J Oral Maxillofac Surg 2010; 39:503-7. [DOI: 10.1016/j.ijom.2009.11.007] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2008] [Revised: 04/28/2009] [Accepted: 11/11/2009] [Indexed: 10/20/2022]
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Mohamed JB, Sudarsan S, Arun KV, Shivakumar B. Rehabilitation using single stage implants. J Indian Soc Periodontol 2009; 13:32-40. [PMID: 20376239 PMCID: PMC2846673 DOI: 10.4103/0972-124x.51893] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2009] [Accepted: 04/11/2009] [Indexed: 11/13/2022] Open
Abstract
Implant related prosthesis has become an integral part of rehabilitation of edentulous areas. Single stage implant placement has become popular because of its ease of use and fairly predictable results. In this paper, we present a series of cases of single stage implants being used to rehabilitate different clinical situations. All the implants placed have been successfully restored and followed up for up to one year.
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Affiliation(s)
- Jumshad B Mohamed
- Postgraduate Student, Department of Periodontics and Implant Dentistry, Ragas Dental College and Hospital, Uthandi, Chennai, India
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Abstract
This case report presents an analysis of the clinical, radiographic, and histological features of a peri-implant lesion around an implant placed immediately after extraction of a tooth with a periapical lesion. A 52-year-old man received an immediate implant (3.75 x 11.5 mm2) placed in the anterior region of the maxilla. Three years after implant placement, the patient presented with swelling in the anterior portion of the maxilla. Radiographic examination showed a well-circumscribed radiolucency around the implant. The implant and the lesion were removed and fixed in 10% buffered formalin and processed. Histological analysis showed 3 types of epithelium: respiratory, cuboidal, and non-keratinized stratified squamous. In the cyst wall peripheral nerves, arteries, veins, and chronic inflammation were present. The diagnosis was nasopalatine duct cyst. We concluded that the nasopalatine duct cyst can develop in association with dental implants. Clinically, the lesion is similar to the classical nasopalatine duct cyst. Histological analysis should be mandatory in all cases of peri-implant lesions and in all dental periapical lesions before immediate implant placement.
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Tözüm TF, Turkyilmaz I, Yamalik N, Karabulut E, Türkyilmaz AS, Eratalay K. Analysis of the possibility of the relationship between various implant-related measures: an 18-month follow-up study. J Oral Rehabil 2008; 35:95-104. [PMID: 18197842 DOI: 10.1111/j.1365-2842.2007.01802.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Better clarification of the long-term relationship among the various implant-related measures could improve the evaluation process for dental implants. Thus, the aim of the present study was to determine the potential correlations among the volumetric features and nitric oxide content of peri-implant sulcus fluid (PISF) and measures of implant stability, and the marginal bone loss. Completely edentulous patients (n=15) treated with dental implants and ball attachment mandibular over dentures were included. Resonance frequency analysis (RFA), marginal bone level measurements, PISF volume and spectrophotometrically determined nitrite levels were recorded for all dental implant sites. Measures for early (n=16) and delayed (n=14) loaded dental implants were comparatively analysed for a period of 18 months. Some random correlations between PISF volume and marginal bone level, PISF nitrite level and marginal bone level and PISF volume and PISF nitrite content, and RFA and PISF volume were observed. However, the only constant correlation was noticed between implant stability (RFA scores) and marginal bone level. This correlation was negative and significant for all dental implants and for delayed loaded implants (P<0.05). The pattern of loading seemed to affect the extent, but not the pattern of this relationship. While some of the implant-related measures may be strongly associated (e.g. dental implant stability and marginal bone level), not all measures from a single implant site are likely to be related. Such associations may be under the influence of a variety of factors including the loading protocol of dental implants.
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Affiliation(s)
- T F Tözüm
- Department of Periodontology, Faculty of Dentistry, Hacettepe University, Ankara, Turkey.
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The Resolution of a Periradicular Lesion Involving an Implant. J Endod 2008; 34:330-5. [DOI: 10.1016/j.joen.2007.12.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2007] [Revised: 12/07/2007] [Accepted: 12/13/2007] [Indexed: 11/19/2022]
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Tözüm TF, Turkyilmaz I, Yamalik N, Karabulut E, Eratalay K. Analysis of the Potential Association of Implant Stability, Laboratory, and Image-Based Measures Used to Assess Osteotomy Sites: Early Versus Delayed Loading. J Periodontol 2007; 78:1675-82. [PMID: 17760535 DOI: 10.1902/jop.2007.070100] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND During the assessments made at presurgical, surgical, and follow-up phases, the clinician may benefit from a wide array of clinical and/or image-based measures. Because analysis of the potential associations among the various measures could improve the evaluation process for dental implants, this study attempted to determine the potential correlations among peri-implant sulcus fluid (PISF) volume, implant stability, nitric oxide content of PISF, and marginal bone loss. METHODS Seventeen completely edentulous patients seeking prosthetic rehabilitation were included. Two ball attachment mandibular overdentures were given to all patients, and early- (N = 18) and delayed-loaded (N = 16) dental implants were compared during 24-weeks of follow-up. Resonance frequency analysis (RFA), marginal bone level, and PISF samples were taken for all dental implants. RESULTS A consistent and negative correlation was observed between RFA measurements and marginal bone level, whereas some correlations also existed between RFA and PISF volume. The pattern of loading seemed to affect the relationship between RFA measurements and marginal bone level and, to a limited extent, the association between PISF volume and nitrite levels. CONCLUSIONS Where the potential associations among various implant-related measures are concerned, the factors that may affect such associations (e.g., healing and loading) need to be considered. Data arising from the analysis of the associations between the wide arrays of available implant-related measures may improve dental practitioners' assessment concerning endosseous dental implants.
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MESH Headings
- Adult
- Aged
- Alveolar Bone Loss/diagnostic imaging
- Alveolar Bone Loss/etiology
- Dental Implantation, Endosseous/adverse effects
- Dental Implantation, Endosseous/methods
- Dental Prosthesis Retention/instrumentation
- Dental Prosthesis, Implant-Supported
- Dental Stress Analysis
- Denture, Complete, Immediate
- Denture, Complete, Lower
- Denture, Overlay
- Female
- Gingival Crevicular Fluid/chemistry
- Gingival Crevicular Fluid/metabolism
- Humans
- Male
- Middle Aged
- Mouth, Edentulous/rehabilitation
- Nitric Oxide/analysis
- Osteotomy/adverse effects
- Osteotomy/methods
- Outcome Assessment, Health Care/methods
- Radiography, Dental, Digital
- Statistics, Nonparametric
- Time Factors
- Vibration
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Affiliation(s)
- Tolga F Tözüm
- Department of Periodontology, Faculty of Dentistry, Hacettepe University, Ankara, Turkey.
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