Peri-Implant Cystic Lesion With Unusual Cellular Changes: A Case Report

This report describes the history and management of a cyst developing in anatomic contact with an immediately placed dental implant.

The lesion presented clinically as a facial swelling of the gingiva adjacent to an osseointegrated and restored maxillary right lateral incisor implant. Radiographs showed a well-circumscribed radiolucency, which was contiguous with the implant surface. After reflection of a mucoperiosteal flap, the lesion was enucleated in toto, and the defect was curetted. The bony defect was grafted, and the lesional tissues were sent for histologic analysis. The results demonstrated the presence of a cyst of unknown origin with some unusual cellular changes in localized areas of the cyst lining resembling ameloblasts. Healing occurred uneventfully, and the patient was monitored for recurrence. At the 2-year follow-up appointment, the patient presented no clinical or radiographic signs of recurrence of the lesion. The etiology of this lesion is unknown.

This case emphasizes the need for histologic diagnosis of peri-implantitis lesions and suggests a need for expansion of the current classification system for peri-implantitis lesions.