Mustafa AYDINBELGE, Ersin YILDIRIM?, Serhan AKMAN³, Cenker Zeki KOYUNCUOĞLU², Burak SELEK?, Mustafa TUNALI¹

OLUŞAN RETROGRAT PERİ-İMPLANTİTİSİN CERRAHİ OLMAYAN TEDAVİSİ: OLGU SUNUMU

Retrograt peri-implantitis (RPİ) implant başarısızlıklarının önemli bir nedenini oluşturmaktadır. RPİ'in çok sayıda potansiyel etiyolojik faktörü ve tedavi yöntemi literatürde tartışılmış olmasına rağmen, nedeni tam olarak açıklığa kavuşturulamamıştır ve tedavi yöntemi konusunda da bir fikir birliği oluşamamıştır. Vaka Raporu Vaka raporu 28 yaşındaki erkek hastada, başarısız endodontik tedaviler sonucu kaybedilmiş üst çene keser dişler bölgesine uygulanan implantlardan birinin apikal bölge çevresindeki radyolosensi'nin tedavisini içermektedir. Bölgeye iki implant uygulamasından üç ay sonra, sol taraftaki implantın apikal bölgesinde radyolosensi ve klinik olarak implant apikaline uzanan sinüs yolu teşhis edildi. Mikrobiyal değerlendirme sonrasında, hastaya antimikrobiyal tedavi uygulandı ve 12 ay boyunca takip edildi. Radyolosent alanın, başka bir tedavi uygulamasına gerek kalmaksızın, kademe kademe azaldığı gözlemlendi. Hastanın, son restoratif tedavisi yapılana kadar herhangi bir şikayeti tespit edilmedi. Sonuç Başarısız endodontik tedavi veya apikal rezeksiyon alanındaki bakteriyal enfeksiyon, RPİ'nin oluşumunda potansiyal bir etiyolojik faktör olabilir. Retrograt periapikal implant lezyonların tedavisinde antibiyotik uygulamasının tek başına bir tedavi seçeneği olabileceği düşünülmektedir.

DEVELOPMENT AND NONSURGICAL TREATMENT OF RETROGRADE PERI-IMPLANTITIS

Retrograde peri-implantitis (RPI) constitutes an important cause of implant failure. Although several potential etiologic factors associated with RPI and potential treatment alternatives have been discussed in the literature, the etiology has not been fully investigated and there is no consensus regarding the treatment method. Case Report: The following report presents the treatment of a 28-year-old man who developed a radiolucency around the apex of the implant in the maxillary incisor region after implant placement replacing tooth with histories of failed endodontic treatments. The radiolucency of the apical part of the left implant and a sinus tract associated with the apical area were detected three months after placement. The patient was placed on a course of antibiotics after the microbial susceptibility testing and monitored periodically over the next 12 months. The radiographic lesion gradually resolved without further treatment. The patient remained asymptomatic throughout the course of final restorative therapy. Conclusion: The possible role of bacterial infection from replacing tooth with histories of failed endodontic and apicoectomy procedures may be a potential etiologic factor in the development of RPI. Only antibiotic theraphy might be one of the treatment approaches to retrograde periapical implant lesions.

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