Retrograde peri-implantitis with no endodontic problems of contiguous teeth: case report

Abstract

Retrograde peri-implantitis (RPI) is a progressive inflammatory lesion that involves the apical portion of the implant and results in loss of integration. Several factors and conditions, both endodontic and non-endodontic, have been hypothesized to have a role in the etiology of RPI, and many treatment protocols have been proposed. A 54-year-old male Caucasian non-smoking patient was treated with an implant rehabilitation in the second premolar area. After about 4 months, a fistula appeared on the buccal mucosa, and a radiolucent area was visible in the apical portion of the implant. The differential diagnosis involved some enlarged bone lesions. Based on both the more in-depth radiographic assessment and histological examination, the final diagnosis of RPI was made, although no apparent causes were identified to explain its occurrence. The lesion was successfully treated only with inflammatory tissue removal and implant debridement and was monitored until complete radiographic bone healing. Continuous, frequent monitoring of implants, especially during the first postoperative months, is essential to identify signs of RPI promptly. A comprehensive understanding of the potential etiopathogenesis of RPI is necessary to both reduce its occurrence and early diagnose the disease, allowing for the application of more appropriate treatment protocols.