Patient: Female, 63-year-old
Final Diagnosis: Missing tooth • periapical granuloma
Symptoms: Multiple recurrent periapical abscesses with pain, swelling extending to eyelid with blurred vision
Clinical Procedure: Enucleation of the residual periapical lesion followed by dental implant placement
Specialty: Dentistry • Pathology
Objective:
Unusual clinical course
Background:
Replacing missing teeth in the anterior region of the jaw can be challenging due to the limited available inter-dental space. Improper selection or inadequate placement of a dental implant in this situation can affect the adjacent anatomical structures negatively. What if, in addition, a residual intraosseous chronic inflammatory lesion was present? The objective of this case report is to demonstrate the step-by-step surgical procedures of replacing a maxillary lateral incisor in a patient with a residual lesion with a satisfactory outcome.
Case Report:
A 63-year-old female patient with an extracted maxillary lateral incisor presented for implant placement. Radiographically, a residual periapical lesion with mild atrophy of the alveolar bone and fairly low density with sparse trabeculation was noted. Owing to the limited restorative space, a Straumann Bone Level Tapered Implant ⌀2.9 mm (Small Cross-Fit connection, Roxolid, SLActive) was placed. Histopathological evaluation revealed a definitive diagnosis of periapical granuloma. After 1 year, the clinical examination revealed a successful outcome, and the patient was satisfied with the result.
Conclusions:
This case report shows a successful clinical and radiographical outcome after 1 year of a 2-piece small diameter dental implant, the Straumann Bone Level Tapered Implant, diameter 2.9 mm, replacing a missing maxillary lateral incisor after enucleating the lesion with histopathological examination.