Reconstructive Approach for Treatment of Retrograde Peri-implantitis in Mandibular Canine Region: A Case Report

Dae-Young Kang

doi:10.32542/implantology.2025010

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2025 Vol.29, Issue 2 Preview Page Next Page

Clinical or Case Report

Reconstructive Approach for Treatment of Retrograde Peri-implantitis in Mandibular Canine Region: A Case Report

30 June 2025. pp. 98-105

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Abstract

Retrograde peri-implantitis (RPI) is a localized inflammatory lesion around the apex of a dental implant, typically occurring shortly after implant placement or prosthetic loading. This report describes the clinical management of RPI in a 62-year-old female patient who presented with tenderness and a sinus tract in the mandibular canine region. Radiographic examination confirmed a periapical radiolucency around implant #43, with intact crestal bone. A reconstructive approach was employed through a buccal window following flap elevation. Granulation tissue was removed, and implant surface decontamination was performed using a titanium brush and adjunctive tetracycline hydrochloride scrubbing. The defect was grafted with deproteinized porcine bone mineral and covered with a collagen membrane. Healing progressed favorably, with symptom resolution and radiographic bone fill observed at the 1.5-year follow-up. This case demonstrated that, when appropriate defect morphology and surgical access are present, RPI can be effectively treated using a reconstructive approach. Preoperative cone-beam computed tomography is essential to assess accessibility, and regular periapical monitoring is advised for patients with prior endodontic pathology to enable early diagnosis and intervention.

Keywords

Bone regeneration

Bone substitutes

Debridement

Dental implants

Peri-implantitis

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