Liviu Feller1, Yusuf Jadwat, Rakesh Chandran, Ilan Lager, M Altini, J Lemmer. 1. *Professor and Head, Department of Periodontology and Oral Medicine, University of Limpopo, Medunsa Campus, Pretoria, South Africa. †Lecturer, Department of Periodontology and Oral Medicine, University of Limpopo, Medunsa Campus, Pretoria, South Africa. ‡Registrar, Department of Periodontology and Oral Medicine, University of Limpopo, Medunsa Campus, Pretoria, South Africa. §Periodontist, Private Practice, Grayston Medical Mews, Sandown, South Africa. ‖Professor, Department of Anatomical Pathology, School of Pathology, University of the Witwatersrand, Johannesburg, South Africa. ¶Honorary Professor, Department of Periodontology and Oral Medicine, University of Limpopo, Medunsa Campus, Pretoria, South Africa.
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.
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.
Authors: Liviu Feller; Yusuf Jadwat; Razia A G Khammissa; Robin Meyerov; Israel Schechter; Johan Lemmer Journal: Biomed Res Int Date: 2015-02-12 Impact factor: 3.411