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Dramatic course of osteomyelitis in a patient treated with immediately placed dental implants suffering from uncontrolled diabetes: A case report.

AbstractPURPOSE:
To report a rare and dramatic complication following immediate dental implant placement in a heavy smoker, who had a delayed diagnosis of uncontrolled diabetes.
MATERIALS AND METHODS:
In this case report we present the dramatic course of a 64-year old female patient treated with five immediate post-extractive dental implants in the mandible, who developed osteomyelitis, which manifested initially as local peri-implant inflammation and progressed into a spontaneous jaw fracture, despite repeated surgical interventions and antibiotic courses over a 3-year period, until diabetes was diagnosed.
RESULTS:
A symptom-free status could be achieved only after partial mandibulectomy, treatment of diabetes and reconstruction with a microvascular fibula free flap.
CONCLUSION:
In the presence of mandibular osteomyelitis refractory to therapy, yet undiagnosed underlying pathologies, such as diabetes, should be investigated and treated urgently.
AuthorsChristian Doll, Stefan Hartwig, Claudia Nack, Susanne Nahles, Katja Nelson, Jan-Dirk Raguse
JournalEuropean journal of oral implantology (Eur J Oral Implantol) Vol. 8 Issue 4 Pg. 405-10 ( 2015) ISSN: 1756-2406 [Print] England
PMID26669550 (Publication Type: Case Reports, Journal Article)
Chemical References
  • Anti-Bacterial Agents
  • Dental Implants
Topics
  • Abscess (microbiology)
  • Alveolar Ridge Augmentation (methods)
  • Anti-Bacterial Agents (therapeutic use)
  • Bone Transplantation (methods)
  • Cutaneous Fistula (diagnosis)
  • Delayed Diagnosis
  • Dental Implants (adverse effects)
  • Diabetes Mellitus, Type 2 (complications, diagnosis)
  • Disease Progression
  • Female
  • Follow-Up Studies
  • Fractures, Spontaneous (etiology)
  • Humans
  • Immediate Dental Implant Loading (adverse effects)
  • Mandibular Diseases (drug therapy, etiology, surgery)
  • Mandibular Fractures (etiology)
  • Mandibular Reconstruction (methods)
  • Middle Aged
  • Osteomyelitis (drug therapy, etiology, surgery)
  • Peri-Implantitis (etiology, surgery)
  • Recurrence
  • Smoking
  • Streptococcal Infections (diagnosis)
  • Streptococcus intermedius (isolation & purification)

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