Fig. 1

Pre operative x-ray

Fig. 2

X-ray after the orthograde retreatment of the premolar

Fig. 3

After anesthesia, a flap was made with preservation of the papilla and the cyst wall was exposed

Fig. 4

The cystic content was drained and the entire wall was subsequently detached to allow the removal of all the granulation tissue

Fig. 5

apical resection of tooth and implant 

Apical obturation with super-EBA

Fig. 6

detail of the removed implant apex

Fig. 7

The flap was repositioned and sutured with an absorbable thread by applying single detached stitches

Fig. 8

Healing of the peridontium after 7 days

Fig. 9

Immediate post operative x-ray

Fig. 10

The author: Dr Jacopo Francinelli

- Degree with honors in Brescia in 2018
- 2020 2nd level post-graduate Master in Clinical and Microsurgical Endodontics at the University of Brescia with full marks and honors
- from 2019 he is clinical tutor in the 3rd year of Dentistry alongside Prof. Salgarello
- from 2021 he is tutor for the aforementioned university master
- He collaborates with the Spedali Civili of Brescia as a freelancer
- He has published articles in national and international journals
- Contract professor for the University of Brescia
- Member of the Italian Academy of Microscopic Dentistry (AIOM) and Italian society of endodontic (SIE)
- Collaborate with colleagues in some private courses focused on endodontics
- He carries out his freelance activity in the province of Brescia dedicating himself mainly to micro-endodontics



When the endodontic lesion involves the apex of an implant in addition to the apex of the tooth, a retrograde peri-impantitis can be established.

In these cases it is necessary to treat both the tooth and the implant with apical surgery, removing all the irritating factor


Mohamed JB, Shivakumar B, Sudarsan S, Arun KV, Kumar TS. Retrograde peri-implantitis. J Indian Soc Periodontol. 2010 Jan;14(1):57-65. doi: 10.4103/0972-124X.65444. PMID: 20922082; PMCID: PMC2933532.

Burdurlu MÇ, Dagasan VÇ, Tunç O, Güler N. Retrograde peri-implantitis: evaluation and treatment protocols of a rare lesion. Quintessence Int. 2021;52(2):112-121. doi: 10.3290/j.qi.a45264. PMID: 33433077.