Periapical Lesion Essay

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DISCUSSION
Many authors consider placement of an implant in a socket with periapical lesion as a contraindication, but several studies which were conducted do not show any significant difference compared to those with healthy sockets.
The disadvantage of the placement of implants into the sockets of teeth with periapical lesions is the potential for implant contamination during the initial healing period because of remnants of the infection.(8,13,162)Bacteroides species can inhabit tooth periapical lesions while being encapsulated in a polysaccharide that promotes its virulence, survival, and importance in mixed infections. Bacteroides forsythus has been shown to persist in asymptomatic periradicular endodontic lesions and may survive in
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These positive results could be explained by various biological events occurring during bone healing process, dependent on aspects such as primary stability of the implant, the surgical technique, the prosthetic load and the associated inflammatory response.(84)

Fugazzotto conducted the only study comparing implants immediately placed into sites with periapical pathology with those immediately placed into sites without periapical pathology in the same patient, it was observed that both treatments yielded comparable results with no statistically significant difference in survival rates.(165)

Regarding the treatment protocol, appropriate clinical procedures to perform the decontamination of the implant’s site, such as antibiotic administration, meticulous cleaning, and alveolar debridement, combined with GBR with or without bone grafting, is suggested to create adequate conditions for bone regeneration and osseointegration despite the previous contamination.(6,85,166)
The natural healing process after tooth extraction normally manages residual infection, but as an infection increases inflammatory activity, infection may result in increased bone resorption and a higher risk of implant stability loss and failure. The presence of granulation tissue in the socket of an infected tooth must be considered as an inflammatory response to bacteria. This reactive

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