Implant Treatment for a Patient With Large Condensing Osteitis: Case Report
Chronic endodontic infections are associated with osseous changes in the peri-apical regions. Dental implants are often placed after the extraction of hopeless teeth with periapical infections. This clinical report describes a patient with a radiopaque mass attached to the root apex of the mandibular right second premolar tooth (No. 45). The differential diagnoses of the radiopaque mass were bone- and tissue-borne diseases. Based on the clinical and radiologic findings (bone density and trabeculation of the bone), the definitive diagnosis of the osseous mass was condensing osteitis. The osseous tumor associated with tooth 45 was atraumatically extracted under local anesthesia. Guided bone regeneration was performed immediately after extraction of tooth 45, and a dental implant was placed in the site after 6 months of healing.
(a) Periapical radiograph of tooth 45; (b) Bone window opening on the area of the infected tooth 45; (c) The large bony mass attached to the extracted tooth 45; (d) The defect shape after complete debridement; (e) Bone graft placed on the socket of the extracted tooth; (f) Prepared implant osteotomies for tooth 45 and tooth 46. (g) Immediate posttreatment view of 1-stage implant placements.
Histopathology of the bony tissue showing compact bony lamellae free of atypia and suggestive of odontoma.
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