A retrospective analysis of implants immediately placed in sites with and without periapical pathology in sixty-four...

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.

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.

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 inflammation 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.

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 significant.