Streptococcus anginosus dental implant-related osteomyelitis of the jaws: An insidious and calamitous entity

Publication date: Available online 31 January 2018
Source:Journal of Oral and Maxillofacial Surgery
Author(s): Sybille Chatelain, Tommaso Lombardi, Paolo Scolozzi
PurposeTo analyze a series of patients with dental implant-related suppurative osteomyelitis of the jaws (DIOMJ) due to Streptococcus anginosus.Patients and MethodsThe charts of all patients seen for osteomyelitis of the jaws between 2011 and 2016 were reviewed. The primary outcome variable was Streptococcus anginosus DIOMJ. Other variables included age, gender, smoking habits, associated co-morbidities, dental implant localization, type of osteomyelitis, delay between dental implant placement and DIOMJ, microbiological examination and antibiogram, antibiotherapy, type of surgery and final outcome.Cases from previous reports of DIOMJ in the literature were also analyzed for comparison.Descriptive statistics were computed.Results26 patients had jaw osteomyelitis, of whom 6 (26%) occurred after dental implant placement. S. anginosus was found in 5 patients and Escherichia coli in one. The osteomyelitis was located in the mandible and associated with a deep neck abscess in all cases. All of the patients were women and were either smokers or had co-morbidities affecting bone metabolism. In all of the cases, dental implants were removed and several surgical debridement procedures (at least two) and prolonged antibiotherapy (6 months on average) were needed. Half of the patients needed a radical surgical reconstructive procedure with partial resection and bone graft.ConclusionThis study demonstrated that Streptococcus anginosus DIOMJ is a particularly aggressive form of osteomyelitis, which has a propensity to develop in the mandible in women in their 60s who are either smokers or have co-morbidities.



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