Apical perimplantitis: etiology, clinic and treatment

Apical peri-implantitis was first described in 1992. This complication does not occur often and is asymptomatic in most cases. However, when immunosuppressive conditions occur associated with stress or a previous acute respiratory viral disease, the symptoms may resemble those of exacerbation of chronic periodontitis. The purpose of the article was to review the etiology, risk factors, features of the clinical course, treatment methods and prognosis of apical peri-implantitis with the author’s clinical examples of the pathology discussed. Based on data from reference sources and our own clinical experience, the article provides a navigational decision-making scheme depending on the form of peri-implantitis. In the presence of a fistula tract, against the background of local symptoms of inflammation, surgical treatment of apical peri-implantitis is recommended. Mechanical (grinding, polishing) and chemical treatment of the implant surface in various ways is Hsu when there is adequate surgical access to the pathological focus with good visualization of the implant surface and bone defect. Otherwise, the treatment of choice is resection of the apical part of the implant or removal of the implant. Methods of guided bone regeneration are applicable only when the doctor is completely confident that the surface of the implant is not infected.