Prevention of retrograde peri-implantitis caused by pulpal/periapical lesions in adjacent teeth: A literature review

Objectives: To present a comprehensive review on retrograde peri-implantitis (RPI), focusing on its epidemiology, etiology, clinical manifestations, classification, treatment, and prevention strategies.

Data: The widespread development of implantology has led to heightened concerns regarding implant failure attributed to peri-implantitis (PI). In contrast to conventional PI, retrograde peri-implantitis (RPI), defined as inflammation originating from the apical of the implant towards the crown, has gained increasing attention. Various factors can contribute to RPI, among which untreated pulpal or periapical lesions from adjacent teeth are considered as main causes.

Sources and study selection: Using PubMed as the source for eligible literature, a total of 73 cases (from 36 articles) were identified for review. The search items are (["retrograde peri-implantitis" OR "periapical peri-implantitis" OR "peri-apical implant lesion*"] AND ["risk factor*" OR "treatment*" OR "prevent*"]).

Conclusions: Currently, clinicians often inadequately address the evaluation and management of pulpal or periapical lesions in the adjacent teeth in RPI, neglecting its causes and further the preventive measures. Overall, RPI influences the success of dental implants and therefore valid diagnosis and prevention are obligatory. Until now, there has been no relative instructions for clinicians. Moreover, new research directions (e.g. molecular biology and immunology) as well as innovative treatment (e.g. lasers and novel materials) may facilitate the precise prevention and early diagnosis of RPI.