The loss of 1 or more teeth is considered a physical and psychological trauma for most individuals, regardless of age or social class. Immediate implant insertion is an excellent alternative to substitute teeth indicated for extraction. Previous studies showed that immediate implants placed on alveolar bone compromised by periapical diseases have similar success rates in comparison to immediate implants placed on healthy alveolar bone.1–5  In cases of chronically infected apical alveolar bone, a severe curettage of the lesion followed by chemical cleaning of the alveolar bone is necessary, as otherwise there is risk of retrograde peri-implantitis.2,6–8  A relevant number of reports of infected implants in chronically infected apical alveolar bone have been observed in literature.9–11 

Macllister et al12  were the first to show clinical cases of periapical lesions on the implants. These lesions were described later...

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