Lesion on palatal aspect: thoughts?
This is a guest case post, from Dr. Ziv Simon, of Surgical Master….
Lesion on palatal aspect of #9. Adjacent implant #8 (Dentsply xive) placed in our practice over 10 years ago. I’m not sure about the brand of the new implant on #9? The lesion: A ganulomatous lesion. No foreign found but the implant surface had no bone. I believe it’s reactive (A reactive lesion refers to a pathological lesion that first forms as a reaction to an external stimulation. It can be mechanical, chemical or thermal. A foreign body can also cause this reaction). Implant identification of #9? Thoughts on this case?
4 Comments on Lesion on palatal aspect: thoughts?
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Dennis Flanagan DDS MSc
8/11/2015
I would seriously consider a biopsy. As you state it will probably come back as a reactive lesion but there is a remote possibility it is something else. Has the pt been eating popcorn? It may be best to curet the lesion and insert minocyline every 2 weeks until it heals then curet the lesion and graft it and cover it with an acryl stent.
Dennis Flanagan DDS MSc
Ziv Simon
8/11/2015
Thanks Dennis. I obtained a biopsy and curreted the peri-implant sulcus. I found nothing suspicious and will wait for the result. The palatal aspect of the implant had bone loss and that may have irritated the gingiva.
Thank you!
CRS
8/12/2015
I would first suspect cement or a foreign body like a popcorn kernel. I agree with the treatment I usually don't send granulomas for path however if unsure of etiology it is appropriate. Bone looks okay. Since you did not place the implant there is always a bit of speculation!
Ziv Simon
8/12/2015
Thanks. There was bone loss on the palatal aspect that obviously doesn't show on a PA
I'll post the biopsy result soon
