Periapicale pathologie is geen belemmering

NTvT 30 maart 2012


Periapicale pathologie is geen belemmering voor directe plaatsing van implantaat.

De prognose van een implantaat na directe plaatsing in de extractiealveole met periapicale pathologie (fistel of granulatieweefsel), is net zo goed als van een implantaat dat is geplaatst in een intacte processus alveolaris.

Abstract
Objectives: 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. The following retrospective analysis assesses implant survival rates when implants are placed in sites with periapical pathology and sites without periapical pathology in the same patient
Methods: 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 or less, with a mean time in function of 64 months. The implants placed in pristine sites were followed in function for 120 months or less, with a mean time in function of 62 months.
Results: Two implants in the central incisor positions of 1 patient demonstrated 2 mm of buccal recession after 46 months in function. These implants were deemed aesthetic 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.
Conclusions: 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.

Bron
Fugazzotto PA. A retrospective analysis of implants immediately placed in sites with and without periapical pathology in sixty-four patients. J Periodontol 2012; 83:182-186.
doi: 10.1902/jop.2011.110016

Klinische relevantie
De resultaten van dit onderzoek zijn gebaseerd op directe plaatsing van een implantaat na extractie bij eenzelfde patiƫnt. Het betrof enkelwortelige gebitselementen. Over de prognose van implantaten in meerwortelige extractiealveolen, met en zonder periapicale pathologie, kan op grond van dit onderzoek geen uitspraak worden gedaan.

Periapicale pathologie is geen belemmering


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