The Resolution of a Periradicular Lesion Involving an Implant

Published reports claim that implants can fail from endodontic pathosis involving teeth adjacent to an implant, from preexisting bacteria in an extraction site that had a history of a tooth having a periradicular lesion, and even from an asymptomatic endodontically treated tooth with no clinical or radiographic evidence of pathosis. This report considers the support offered for an endodontic connection to implant failure, and it presents a case that conflicts with the premise that endodontic involvement causes implant failure. The diagnosis and treatment of a radiolucent lesion associated with an implant is described. Although initially interpreted as indicating a failing implant, the etiology of the radiolucency was a necrotic pulp in a maxillary lateral incisor with resorption. Nonsurgical endodontic treatment that combined Ca(OH)2 for interim treatment and mineral trioxide aggregate for final obturation completely resolved the periradicular lesion abutting the implant and successfully retained both the implant and the resorbed lateral incisor.