Doll Christian, Hartwig Stefan, Nack Claudia, Nahles Susanne, Nelson Katja, Raguse Jan-Dirk
Eur J Oral Implantol. 2015 Winter;8(4):405-10.
To report a rare and dramatic complication following immediate dental implant placement in a heavy smoker, who had a delayed diagnosis of uncontrolled diabetes.
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.
A symptom-free status could be achieved only after partial mandibulectomy, treatment of diabetes and reconstruction with a microvascular fibula free flap.
In the presence of mandibular osteomyelitis refractory to therapy, yet undiagnosed underlying pathologies, such as diabetes, should be investigated and treated urgently.
报告一例重度吸烟者即刻种植术后出现的罕见且严重的并发症,该患者糖尿病未得到控制且诊断延迟。
在本病例报告中,我们呈现了一名64岁女性患者的戏剧性病程。该患者下颌骨接受了5颗拔牙后即刻种植,发生了骨髓炎,最初表现为种植体周围局部炎症,尽管在3年期间反复进行手术干预和抗生素治疗,仍发展为自发性颌骨骨折,直至糖尿病被诊断出来。
仅在进行部分下颌骨切除、糖尿病治疗以及采用游离腓骨微血管皮瓣重建后,才实现了无症状状态。
对于治疗难治的下颌骨骨髓炎,若存在未被诊断出的潜在疾病,如糖尿病,应紧急进行调查和治疗。