Successful medical treatment of an implant periapical lesion: a case report.

An implant periapical lesion (IPL) is an infectious-inflammatory alteration surrounding an implant apex. In the English literature, the treatments for IPL have all been surgical methods. We present a case of successful treatment of an IPL with medical methods. A 36-year-old man underwent placement of two implants in the molar region of the right mandible. About one month later, the patient had pain at the surgical site and radiolucencies at the apical portion of the two implants on radiographs. Systemic antibiotic treatment with amoxicillin and acetaminophen was instituted, but the symptoms did not improve. The medications were changed to prednisolone, augmentin and mefenamic acid and the patient's symptoms completely subsided. This case was successfully treated using medical methods. The IPL disappeared on radiography and there were no symptoms or signs of recurrence at the 2-year follow up. We report a successful case of an IPL using medical methods. However, additional data are certainly necessary for a more comprehensive understanding of the etiopathologic and clinical problems related to an IPL.