ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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Title An Implant Apicoectomy Is An Acceptable Treatment For Continuing The Survival Of An Implant Presenting With A Periapical Lesion
Clinical Question In an otherwise healthy adult patient with a lesion at the apical portion of their dental implant, is an implant apicoectomy sufficient treatment to save the implant?
Clinical Bottom Line Thirty-eight of the thirty-nine implants treated with an apicoectomy remained stable and continued to function at least for as long as the follow-ups lasted (avg 4.54 yrs, longest 15+ yrs).
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 17465352Balshi/200735 patients mean age 58.3 with periapical lesionsCase Control
Key results38/39 implants treated with an apicoectomy remained stable and had no further complications
Evidence Search (("Periapical Abscess"[Mesh]) AND "Apicoectomy"[Mesh]) AND "Dental Implants"[Mesh]
Comments on
The Evidence
Balshi and colleagues reported a case control study of the treatment success on apicoectomies on implants with periapical lesions. It was not explained whether or not they performed a comprehensive and detailed search for relevant trials. The individual studies were assessed for validity using clear criteria. They found the evidence to be of good quality. No meta-analysis was done.
Applicability The Balshi article used subjects very representative of my patients. Implant apicoectomies would be feasible in our clinical setting. Our patients could potentially benefit from this procedure allowing survival of their implant. However, there is also the chance of implant failure still occurring along with unnecessary trauma occurring on the surrounding periodontium. We would need to discuss with each patient whether the potential harms that could occur for this procedure would discourage the patient.
Specialty/Discipline (General Dentistry) (Oral Surgery) (Periodontics)
Keywords Implant, periapical lesion, apicoectomy
ID# 2430
Date of submission: 03/04/2013spacer
E-mail vogelj@livemail.uthscsa.edu
Author John Vogel
Co-author(s)
Co-author(s) e-mail
Faculty mentor/Co-author Adriana Green, DDS, MPH
Faculty mentor/Co-author e-mail greenav@uthscsa.edu
Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?)
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None available
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Comments on the CAT
(FOR PRACTICING DENTISTS' and/or FACULTY COMMENTS ON PUBLISHED CATs)
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