Mandibular Osteomyelitis Following Implant Placement

J Oral Maxillofac Surg. 2017 Dec;75(12):2560.e1-2560.e7. doi: 10.1016/j.joms.2017.07.169. Epub 2017 Aug 3.

Abstract

Purpose: Mandibular osteomyelitis is relatively rare except in cases of osteoradionecrosis or medication-related osteonecrosis. The purpose of this case report is to highlight a rare but devastating complication of dental implant surgery.

Materials and methods: The case of a patient who developed mandibular osteomyelitis after implant placement, which was resistant to long-term antibiotic therapy and required radical surgical treatment with fibular free flap reconstruction, is reviewed as is the related literature.

Results: The most frequent etiologies are odontogenic and traumatic; however, hematogenous spread also exists. It usually affects patients with systemic conditions, such as diabetes mellitus, malnutrition, malignancy, or immune deficiency. The infection is usually polymicrobial. Concerning dental implant complications, the literature is comprehensive on the mechanical etiologies of implant failure and the infectious etiologies of peri-implantitis. Mandibular osteomyelitis treatment is a long and challenging process requiring long-term antibiotic therapy and multiple surgeries.

Conclusion: The pathophysiology and treatment of mandibular osteomyelitis are discussed.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Dental Implantation, Endosseous*
  • Humans
  • Male
  • Mandibular Diseases / diagnosis*
  • Mandibular Diseases / etiology
  • Middle Aged
  • Osteomyelitis / diagnosis*
  • Osteomyelitis / etiology
  • Postoperative Complications / diagnosis*