CBCT Teeth Case Analysis – Apical Infection Near Dental Implant

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CBCT Teeth Case Analysis – Apical Infection Adjacent to Dental Implant

Case Overview

This CBCT image shows a posterior mandibular area with a natural molar next to an existing dental implant. The natural tooth presents a clear apical radiolucency, indicating infection at the root apex. Bone density changes are visible between the infected tooth and the implant site.


Full Analysis and Diagnosis

Clinical Findings

  • Natural molar with deep restoration

  • Visible apical lesion at root tip

  • Adjacent implant appears integrated

  • Localized bone loss near apical area

  • Cortical bone still intact

Radiographic Interpretation

  • Periapical radiolucency suggests chronic apical periodontitis

  • Bone trabeculation is reduced near infection site

  • Infection is in close proximity to implant threads

  • No immediate implant mobility, but risk is present

Diagnosis

  • Chronic apical infection of natural tooth

  • Secondary risk of peri-implant bone involvement


Time Frame to Heal

With Proper Treatment

  • Infection control: 7–14 days

  • Pain and inflammation reduction: within 1 week

  • Bone healing begins: 4–6 weeks

  • Radiographic bone recovery: 3–6 months

Without Treatment

  • Infection may spread toward implant

  • Progressive bone loss

  • Increased risk of peri-implantitis

  • Possible implant failure


Process to Execute (14-Day Window)

Days 1–3

  • Clinical exam and CBCT evaluation

  • Identify infection source

  • Prescribe antibiotics if indicated

Days 4–7

  • Root canal treatment or retreatment

  • Drainage if abscess is present

  • Occlusal adjustment if needed

Days 8–14

  • Follow-up assessment

  • Monitor implant stability

  • Evaluate soft tissue healing


Issues That Will Scale Up If Untreated

  • Expansion of apical lesion

  • Bone loss reaching implant surface

  • Chronic pain and swelling

  • Surgical intervention required

  • Implant loss in advanced cases


Clinical Comments

Early endodontic treatment is strongly advised. The implant is currently stable, but adjacent apical infection poses a serious long-term risk. Timely intervention can preserve both the tooth and the implant.


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