Abstract | PURPOSE: 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.
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Authors | Christian Doll, Stefan Hartwig, Claudia Nack, Susanne Nahles, Katja Nelson, Jan-Dirk Raguse |
Journal | European journal of oral implantology
(Eur J Oral Implantol)
Vol. 8
Issue 4
Pg. 405-10
( 2015)
ISSN: 1756-2406 [Print] England |
PMID | 26669550
(Publication Type: Case Reports, Journal Article)
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Chemical References |
- Anti-Bacterial Agents
- Dental Implants
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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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