Dental implants are a popular solution for replacing missing teeth. While it is uncommon, some patients do experience persistent pain after the placement of an implant. An apicoectomy, which removes the implant's tip, can effectively treat infections localized in the implant's apex, allowing cleaning, and reconstructing the affected area while preserving the implant itself. This case report presents an alternative treatment for orofacial pain caused by a misaligned implant with its apex extending beyond the bone contour, utilizing the apicoectomy technique. A 63-year-old Asian female experienced persistent left-side facial pain, along with nasal discharge and tenderness around her upper left central implant. A 3D X-ray (cone beam computed tomography CBCT) revealed improper implant positioning, leading to inadequate bone coverage, with its tip extending outside the bone contour. Implant apicoectomy and soft tissue augmentation with a palate graft was performed. Two weeks post-surgery, the patient reported complete relief from her orofacial pain and nasal discharge. This technique offers a practical option for addressing an implant that is not infected but has its tip outside the bone contour, allowing for the retention of a fully integrated implant in the oral cavity.
Durán-Garnica et al. (Sat,) studied this question.