Wang Ruijie, Gan Yujian, Zhao Yaqi, Wen Shuyi, Lin Yusen, Zeng Yan, Zheng Xiao, Rong Mingdeng
Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou, China.
Clin Implant Dent Relat Res. 2025 Apr;27(2):e70028. doi: 10.1111/cid.70028.
Peri-implant pyogenic granuloma (PG) is a benign vascular lesion associated with dental implants, typically resulting from local irritation. While peri-implant PG can ultimately lead to implant failure, there is no established consensus regarding the feasibility of reimplantation after implant removal.
A 66-year-old female patient presented to the clinic with painful erythematous and swollen gingiva in the left posterior maxillary region, accompanied by a bleeding tendency. The patient had received two titanium alloy implants in the same area 7 and 3 years ago, respectively, for missing posterior teeth. Clinical examination revealed soft tissue hyperplasia and easy bleeding upon touch around the implants supporting the prosthetic restoration at Sites 24 and 25. Radiographic evaluation showed no significant bone resorption. Initial management included the prosthetic restoration removal, placement of healing abutments, and peri-implant curettage with the application of medication. After 10 days, the lesion was surgically excised, and histopathological analysis confirmed the diagnosis of PG. Despite initial treatment, the lesion recurred 2 weeks after excision. A second excision, coupled with debridement and local medication, was performed. However, the PG recurred 3 weeks later, necessitating the implants removal at sites 24 and 25. Following implants removal, the surgical sites were monitored for 3 months, during which no PG recurrence was observed. Given the patient's systemic health and the local soft and hard tissue conditions, the tooth at site 26, which had a poor prognosis, was also extracted. Subsequently, reimplantation was performed at sites 24, 25, and 26. After a six-month healing period, the prosthetic restoration was completed. Three and six months post-restoration, clinical and radiographic evaluations confirmed stable outcomes, with no abnormalities in the peri-implant soft or hard tissues.
Peri-implant PG is a relatively rare soft tissue complication associated with dental implants and is characterized by a high recurrence rate, often leading to implant removal. This case illustrates successful reimplantation at the original site following implant removal due to PG, providing clinical evidence that reimplantation after PG-related implant failure is feasible. However, a thorough evaluation of both systemic and local factors is essential to minimize recurrence and ensure successful outcomes.
种植体周围化脓性肉芽肿（PG）是一种与牙种植体相关的良性血管性病变，通常由局部刺激引起。虽然种植体周围PG最终可能导致种植失败，但对于种植体取出后再植入的可行性尚无定论。
一名66岁女性患者因左上颌后牙区牙龈疼痛、红斑和肿胀伴出血倾向就诊。患者分别于7年前和3年前在同一区域植入了两枚钛合金种植体，用于修复后牙缺失。临床检查发现，24和25位点支持修复体的种植体周围软组织增生，触诊易出血。影像学评估显示无明显骨吸收。初始治疗包括拆除修复体、放置愈合基台以及对种植体周围进行刮治并用药。10天后，对病变进行手术切除，组织病理学分析确诊为PG。尽管进行了初始治疗，但病变在切除后2周复发。进行了第二次切除，并联合清创和局部用药。然而，PG在3周后再次复发，因此需要拔除24和25位点的种植体。种植体拔除后，对手术部位进行了3个月的监测，期间未观察到PG复发。鉴于患者的全身健康状况以及局部软硬组织情况，对预后较差的26位点牙齿也进行了拔除。随后，在24、25和26位点进行了再植入。经过6个月的愈合期后，完成了修复体修复。修复后3个月和6个月，临床和影像学评估证实结果稳定，种植体周围软硬组织无异常。
种植体周围PG是一种与牙种植体相关的相对罕见的软组织并发症，其特点是复发率高，常导致种植体拔除。本病例说明了因PG导致种植体拔除后在原部位成功进行再植入，为PG相关种植失败后再植入可行提供了临床证据。然而，全面评估全身和局部因素对于减少复发和确保成功结果至关重要。
