(PR56) A Retrospective Study on the Association Between Previously Root Canal Treated Teeth with Persistent Apical Periodontitis and the Subsequent Development of Peri-implantitis at the Same Site

Abstract:

Objectives: It was reported that a common etiology of apical retrograde peri-implantitis is endodontic infection from neighboring teeth, which was diagnosed within 6 months after implant placement. Also an increase of Prevotella and Fusobacterium were associated with apical periodontitis and a failed implant. The aim of this study was to evaluate the incidence of peri-implantitis in sites with teeth that had been previously endodontically treated, had persistent apical periodontitis and were subsequently extracted. We hypothesized that persistent apical periodontitis with high PAI scores (3-5) would be associated with developing peri-implantitis.

Methods: 217 charts were reviewed and 106 charts met the inclusion and exclusion criteria. A chi-square analysis was utilized to calculate the odds ratio of developing peri-implantitis.

Results: The prevalence of persistent apical periodontitis with a high PAI score (3-5) was 10.4% and the prevalence of Peri-Implantitis was 18.9%. Chi-square analysis showed a statistically significant association between the patients with peri-implantitis at a site with a history of persistent apical periodontitis and PAI score of ≥3 versus patients with peri-implantitis at a site without a history of persistent apical periodontitis with PAI score of ≤2. Patients in the high PAI score group had 4.4 times higher odds of peri-implantitis being present versus patients with low PAI scores.

Conclusion: Patients with endodontically treated persistent apical periodontitis exhibiting high PAI scores should exhaust all endodontic treatment options, including microsurgical endodontics(given well-referenced high success rates), before considering implant placement, recognizing the higher risk of peri-implantitis in these patients.