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International Journal of Oral Implantology



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Int J Oral Implantol (Berl) 8 (2015), No. 4     7. Dec. 2015
Int J Oral Implantol (Berl) 8 (2015), No. 4  (07.12.2015)

Page 405-410, PubMed:26669550

Dramatic course of osteomyelitis in a patient treated with immediately placed dental implants suffering from uncontrolled diabetes: A case report
Doll, Christian / Hartwig, Stefan / Nack, Claudia / Nahles, Susanne / Nelson, Katja / Raguse, Jan-Dirk
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.

Keywords: fibula free flap, immediate dental implant placement, osteomyelitis, uncontrolled diabetes