Periapical pathology may not be a contraindication for immediate implant placement

February 1, 2012

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Background: Many patients requiring implant therapy present with hopeless teeth exhibiting periapical pathology. The
advisability of implant placement in such situations has not
been conclusively determined.
Methods: Sixty-four patients underwent therapy in their
maxillary incisor region. Treatment consisted of immediate
implant placement in a site demonstrating periapical pathology, and immediate implant placement in a ‘‘pristine’’ site,
either during the same visit or during separate visits. The implants placed in the sites demonstrating periapical pathology
were followed in function for £117 months, with a mean time in
function of 64 months. The implants placed in pristine sites
were followed in function for £120 months, with a mean time
in function of 62 months.
Results: Two implants in the central incisor positions of one
patient demonstrated 2 mm of buccal recession after 46
months in function. These implants were deemed esthetic failures, despite the absence of in?ammation and continued clinical implant immobility, yielding cumulative survival rates of
98.1 and 98.2 for implants placed in sites with periapical pathology and implants placed in sites without periapical pathology, respectively, according to published criteria.
Conclusions: Implants immediately placed in sites demonstrating periapical pathology yielded results comparable to
those immediately placed in pristine sites. The difference in
survival rates was not statistically signi?cant. J Periodontol
Dental implants; dental materials; pathology, oral; peri