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A surgical approach to the management of periapical implant lesions

Left: Clinical photograph before extractions. Right: Lateral view at the 1-year follow-up. (Photographs: Dr. Blaya Tárraga)
Dr. Juan Antonio Blaya Tárraga et al.

Dr. Juan Antonio Blaya Tárraga et al.

Fri. 26. October 2018


Periapical implant lesions may be a cause of early failure of implants. The purpose of this article is to describe the surgical treatment of the periapical implant lesion and its intraoperative approach.

Case presentations: Three patients with periapical implant lesions (2 in the maxilla and 1 in the mandible) after implant placement are described. All three patients reported inflammation and pain. Periapical and panoramic radiographic examination showed periapical radiolucency around the three implants. The diagnosis was acute suppurative stage in all three cases. After surgical treatment, all of the implants survived. Clinical and radiographic controls showed signs of health with a follow-up of three, six and four years, respectively.

Conclusion: In the patients studied, pain in the area after implant placement suggested a periapical implant lesion. The surgical approach used to remove the granulation tissue showed good results. Up to 6-year clinical and radiographic controls, all three cases showed complete healing of soft and hard tissue. Diagnosis and early treatment are crucial to ensure a correct osseointegration process and avoid implant failure.

Editorial note: The full article was published in the 3/2018 issue of the Journal of Oral Science and Rehabilitation. It can be accessed free of charge at www.dtscience.com.


Interview with Dr. Juan Antonio Blaya Tárraga

Dr. Blaya Tárraga, why did you conduct the research reported on in this paper?
We conducted this research because there are few articles that describe a surgical approach to treating the periapical implant lesion.

For what reasons could others cite your paper?
The etiology of the periapical implant lesion is multifactorial as described in the literature. In this article, three surgical approaches with different etiologies are described.

How could your study’s findings have an impact on dentistry?
The impact on dentistry of this article may be an increase in knowledge about this lesion and its surgical management. Clinical recommendations could be: monitor the implants since their placement, diagnose the lesion in time and establish a treatment protocol.

What is the relevance of your study’s findings to the daily practice of a dentist?
The relevance of this study in the daily practice is the improvement of the early diagnosis of periapical implant lesions and increased survival of the implants treated.

What are your recommendations for further investigation of the topic of your article?
Studies that provide a greater sample with a randomized controlled design are necessary. Some variables may be interesting to study: the nature of the adjacent and extracted teeth, the time of implant placement, the time from diagnosis to surgical treatment and the different surgical approaches (guided bone regeneration, resection of the implant, irrigation agents, antibiotics, etc.).