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Dental implants are a treatment option for edentulous spaces. Placing implants involves a surgical procedure requiring a high level of attention to detail. There are risks associated with implants, such as peri-implantitis, failure of osseo-integration and peri-apical implantitis. The latter condition can present after implant placement, and presents radiographically as a radiolucency around the apical part of the implant, similar in appearance to a peri-apical lesion of a non-vital tooth. The aetiology of this condition remains controversial. This article presents some of the current literature and the case report demonstrates the successful surgical management of peri-apical implantitis.
CPD/Clinical Relevance: The presentation, potential aetiologies and the successful clinical management of peri-apical implantitis can be useful to clinicians.
Article
Implant peri-apical pathology has been referred to as apical peri-implantitis, retrograde peri-implantitis, or peri-apical implantitis. Implant peri-apical pathology was described by McAllister et al1 as an injury that occurs in the apical portion of an implant causing failure of osseo-integration. Sussman and Moss2 defined it as an infectious–inflammatory process of the tissues surrounding the implant apex.
The aetiology of peri-implant disease remains controversial. Some have suggested that it might be caused by bacterial contamination of the implant during the surgical procedure itself. Others have postulated that it might be caused by a resurgent peri-apical infection in that area, or possibly due to a retained root tip, or by infection spreading from the peri-apical lesion of an adjacent tooth.3 Other suggested explanations for implants developing localized peri-apical pathology have included overheating at the tip of the final drill and/or overloading of the bone.3
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