IMPLANT PERIAPICAL LESIONS - CLINICAL, HISTOLOGIC, AND HISTOCHEMICAL ASPECTS - A CASE-REPORT

A new entity, the ''implant periapical lesion,'' has recently been des cribed. The etiology of this condition could be attributed to overheat ing of the bone, overloading of the implant presence of a pre-existing infection or of residual roof particles and foreign bodies in the bon e, implant contamination during production or during insertion, or pla cement of the implant in an infected maxillary sinus. In this report a titanium plasma-sprayed implant had been inserted into the mandible o f a 53-year-old patient; after 5 months a fistula developed and periap ical radiography showed a large radiolucent image around the apical po rtion of the implant, The implant was removed, and histologic examinat ion showed necrotic bone and an inflammatory infiltrate inside the hol low portion of the implant, The etiology of the implant failure in thi s instance could be related to a fracture and vascular impairment of t he bone inside the implant during insertion, to external contamination of the implant or to the poor bone quality of the implant site.