Surgical management of acute retrograde peri-implantitis: a review of current literature

Aims: Periapical implant lesions, also named apical peri-implantitis or retrograde peri-implantitis, were described since 1992, and are characterized by progressive bone loss at the periapex of the implant. Several case reports have suggested these lesions are possible causes for early implant failure. The aim of this article was to review the Literature to identify current knowledge on surgical management of acute retrograde peri-implantitis. Methods: The Authors conducted an independent search of the literature, for reports published from 1st January 2008 up to 1st December 2018 in English in several databases: Pubmed, Web of Science, SciVerse, MEDLINE and through The Cochrane Database of Systematic Reviews. Only articles reporting data on the surgical treatment of dental implants affected by retrograde peri-implantitis were included. Articles with unclear or unavailable data or with less than 6 months of follow- up were excluded. Results: A total of 47 records was identified through database searching. After removal of duplicates, twenty-three studies were selected for title and abstract analysis, with 14 articles considered for detailed screening. Eight studies were included in the present review: four case series and four case reports. A total of 36 dental implants was treated, with follow-up ranging from 6 months to 6 years. Successful resolution of the peri-apical lesion was observed in 34/36 implants (94.5%), with complete radiographic bone fill and absence of further symptomatology. Conclusions: Several surgical techniques have been reported for lesions, with proper endodontic evaluation of adjacent teeth. Surgical and chemical debridement of the implant associated with GBR considered the preferred treatment option.