Retrograde Peri-implantitis: A Scoping Review of Current Understanding of a Rare Complication in Dental Implants

Retrograde peri-implantitis is a rare complication of dental implants, characterized by symptomatic periapical lesions at the implant apex. Several etiological factors have been identified with an increased risk associated with implants placed near teeth with periapical lesions. The present study undertook a scoping review to discuss the etiological factors and recent classification of retrograde peri-implantitis and summarize current literature-based guidelines for its management. An online database search was performed to identify studies related to retrograde peri-implantitis using the following terms: retrograde peri-implantitis, implant apical lesions, and periapical implant lesion. A total of 167 studies were initially identified, of which 38 met the inclusion criteria. These comprised case reports and retrospective studies, including 14 case reports that presented various management strategies for retrograde peri-implantitis. Half of these reports describe adjacent teeth with failed root canal treatments or periapical infections. Four studies utilized nonsurgical treatment to manage the lesion, including antibiotics for root canal treatment of the adjacent teeth. The remaining cases involved surgical interventions, such as implant debridement, apical resection, implant removal, and bone grafting. This review discusses the etiological factors of retrograde peri-implantitis, presents the recent classification of the lesion, and summarizes current literature-based guidelines for its management.