Implant Apicoectomy as a Minimally Invasive Alternative to Explantation in Retrograde Peri-Implantitis: A Case Report...

Background/Objectives: Implant explantation is often considered the standard treatment for severe peri-implant inflammatory lesions, including cases with apical involvement. However, this approach is relatively invasive and aggressive, which can lead to significant loss of bone and soft tissues, potentially compromising future prosthetic rehabilitation, particularly in the esthetic zone. This study aimed to present implant apicoectomy as a conservative alternative that would allow preservation of implant stability while effectively treating localized inflammation. Methods: This case report presents a female patient who was diagnosed with retrograde peri-implant inflammation, and an implant apicoectomy was performed as a conservative approach to implant explantation. The procedure was carried out using a minimally invasive microsurgical technique. Results: The treatment resulted in complete clinical and radiographic healing, maintenance of implant osseointegration and stability, and resolution of clinical symptoms, including fistula closure. No recurrence of periapical infection was observed during the twelve-month clinical and radiological follow-up visit. Conclusions: Implant apicoectomy may be considered a minimally invasive and effective alternative to explantation in selected cases of retrograde peri-implantitis, preserving hard and soft-tissue architecture while maintaining implant functionality. This approach may be particularly beneficial in esthetic regions where preservation of tissue architecture is critical for optimal clinical outcomes.