Mandibular osteomyelitis following implant placement

Publication date: Available online 3 August 2017
Source:Journal of Oral and Maxillofacial Surgery
Author(s): Matthias Schlund, Gwenael Raoul, Joel Ferri, Romain Nicot
Mandibular osteomyelitis is relatively rare except in cases of osteoradionecrosis or medication-related osteonecrosis. The most frequent etiologies are odontogenic and traumatic, however, hematogenous spread also exists. It usually affects patients suffering from systemic diseases such as diabetes mellitus, malnutrition, malignancy or immune deficiency. The infection is nearly always polymicrobial.Related to dental implant complications, the literature is comprehensive related to mechanical etiologies of implant failure as well as on the infectious side, on the subject of peri-implantitis. Mandibular osteomyelitis treatment is a long and challenging process requiring long-term antibiotic therapy and multiple surgeries.The purpose of this case report is to highlight a rare but devastating complication of dental implant surgery. The pathophysiology and the treatment of mandibular osteomyelitis are discussed. The case of a patient who developed mandibular osteomyelitis following implant placement, which was resistant to long-term antibiotic therapy requiring radical surgical treatment with fibular free flap reconstruction, is reviewed as well as the related literature.



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