Trepanation and curettage treatment for acute implant periapical lesions.

Six dental implants in six patients with periapical lesions were inserted and underwent trepanation and thorough curettage. During surgery, the lesion area was irrigated with copious natural saline and chlorhexidine and the bone defects were treated with tetracycline paste. The six implants were stable and asymptomatic postoperatively. The implants were loaded after 3 months. Radiologically, the radiolucency in the apical part disappeared gradually. These prostheses have functioned satisfactorily with no further complication during the follow-up period. For cases in which small lesions initially appear soon after implant placement, trepanation and curettage of the periapical lesion without resection of the apical part of the implant or bone substitute material and/or autogenous bone grafting is an effective management option. A rapid and exact diagnosis is important for treating implant periapical lesions.