Active Implant Peri-Apical Lesion: A Case Report Treated Via Guided Bone Regeneration With a 5-Year Clinical and Radiographic Follow-Up
Implant peri-apical lesion (IPL) is a periapical lesion, usually asymptomatic, in which the coronal portion of the implant achieves a normal bone to implant interface. A case of IPL following immediate implant placement and treated with guided bone regeneration (GBR) principles is described. Five-year clinical and radiographic follow-up with cone-beam assessment showed complete healing of the bone. GBR principles applied to IPL could completely solve the lesion.

Figure 1. Pre-operative clinical view. Figure 2. Implant immediately placed in the postextraction socket. Figure 3. Peri-apical radiograph immediately after implant placement. Figure 4. Clinical view three months following the implant placement. It is possible to observe the formation of a sinus tract on the facial aspect of the implant. Figure 5. A peri-apical radiolucency on the implant was evident. Figure 6. Full thickness flap was raised and granulation tissue was noted at the apex of the implant.

Figure 7. The granulation tissue was completely removed. Figure 8. A bioabsorbable membrane was placed over the defect. Figure 9. Peri-apical radiograph after 5 years the implant placement showed new bone formation at the apical region of the implant. Figure 10. Clinical view 5 years after the implant placement. Figure 11. Cone-beam assessment confirmed new bone formation at the apical region of the implant.
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