Implant periapical lesions: etiology and treatment options

Implant failures due to apical pathology are conditions that have not been extensively studied nor reported in the literature. The implant periapical lesion (IPAL) has different symptoms, and several etiologies have been proposed in the literature. This article reviews cases of IPAL reported in peer-reviewed journals and presents possible treatment options. Analysis of the data collected was performed based on diagnosis, cause of extraction of the natural tooth, location, period of implant placement, implant surface, and treatment approach. Even the data presented in this review are based on few reported cases the etiology of these lesions seems to be multifactorial or with an unknown origin. Contamination of the implant surface, bone overheating during surgery, excessive torquing of the implant, poor bone quality, perforation or thinning of the cortical bone, premature or excessive load over the fixture, fracture of the bone inside the hollow portion of the hollow implant, and an implant placement in an infected maxillary sinus have been discussed. In general, areas around endodontically compromised teeth should be carefully analyzed prior to implant placement to prevent implant failures.