title: The importance of histopathological diagnosis in the management of lesions presenting as peri-implantitis.
abstract: OBJECTIVE
  This study is a histopathological analysis of lesions clinically diagnosed as peri-implantitis (PI).
  
  
  METHODS
  This retrospective study included microscopic findings in 117 peri-implant biopsies from lesions presenting clinical and radiographic features of peri-implantitis.
  
  
  RESULTS
  The study group included 117 biopsies, mean age 55.2 years; 60.9% of biopsies were from failing implants during explantation, the remaining from surviving implants. All cases showed microscopic evidence for inflammation; however, although 41% exhibited only nonspecific inflammation, 29.9% exhibited actinomyces-related inflammation, 18.8% pyogenic granuloma (PG), and 10.3% giant cell granuloma (GCG). Differences in implant failure rates between pathological diagnostic groups were not statistically significant. Lesions with simple inflammation could not be distinguished clinically or radiographically from the potentially destructive lesions.
  
  
  CONCLUSIONS
  There were no clinical features which could distinguish PI with simple inflammation from potentially destructive lesions mimicking PI, such as GCG, PG, and actinomycosis. However, to control GCG and PG surgical procedures would be recommended, actinomycosis would indicate specific antibiotics, whereas in nonspecific inflammation, these measures may not be indicated. The results of the present study provide evidence for the importance of early microscopic examination of lesions presenting clinically as peri-implantitis, a step toward more accurate diagnosis and improved treatment of PI and lesions mimicking PI.
authors: Tel-Aviv Sourasky Medical Center, Tel-Aviv; Department of Pathology, Sackler School of Medicine, Tel-Aviv University, Ramat-Aviv, Israel.
authors: Ilana
authors: I
authors: Kaplan
authors: Avraham
authors: A
authors: Hirshberg
authors: Benjamin
authors: B
authors: Shlomi
authors: Ori
authors: O
authors: Platner
authors: Avital
authors: A
authors: Kozlovsky
authors: Ronen
authors: R
authors: Ofec
authors: Devorah
authors: D
authors: Schwartz-Arad
mesh_terms: D000196:Actinomycosis / Q000175:diagnosis; D000328:Adult; D000368:Aged; D001706:Biopsy; D015921:Dental Implants / Q000009:adverse effects*; D019232:Dental Restoration Failure; D003937:Diagnosis, Differential; D005260:Female; D006099:Granuloma / Q000175:diagnosis; D006801:Humans; D008297:Male; D008875:Middle Aged; D057873:Peri-Implantitis / Q000175:diagnosis* / Q000473:pathology; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D015921:Dental Implants
keywords: actinomyces; giant-cell-granuloma; inflammation; peri-implantitis