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1例患有未控制糖尿病且即刻植入牙种植体的患者发生骨髓炎的戏剧性病程:病例报告

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

作者信息

Doll Christian, Hartwig Stefan, Nack Claudia, Nahles Susanne, Nelson Katja, Raguse Jan-Dirk

出版信息

Eur J Oral Implantol. 2015 Winter;8(4):405-10.

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.

摘要

目的

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。

材料与方法

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。

结果

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。

结论

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。

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