ABSTRACT
Peri-implant bone necrosis (PIBN) is a rare yet potentially serious phenomenon contributing to implant failure. It can be challenging to determine the exact etiology, especially when multiple intricate factors are involved. This case series reports on the successful management of PIBN during early and late implant placement and peri-implantitis-associated bone necrosis, with likely causes being bone over-compression during implant placement or a consequence of periimplantitis. This case series presents five cases of peri-implant bone necrosis, with three cases occurring immediately after implant placement and the other two presenting a delayed inflammatory process of peri-implantitis between one and five years after implant placement. Clinical presentation and histopathological evaluation data present ten failed implants managed with the removal of implants and the associated necrotic bone.
All the cases were successfully managed without any signs of recurrence. Two cases confirmed bone necrosis via biopsy, illustrating the typical pattern of bone necrosis: multiple non-vital bone fragments surrounded by acute and chronic inflammatory cells and empty lacunae. All cases were successfully managed by removing necrotic bone and associated implants, with no indication of bone necrosis recurrence.
Conclusions: This case series report highlights the unusual early and delayed implant failure associated with peri-implant bone necrosis. This condition most likely results from bone over-compression during implant placement or is a sequela of the inflammatory process of peri-implantitis.
