title: Draining orocutaneous fistula associated with a failing subperiosteal implant: report of a case.
abstract: The use of mandibular subperiosteal implants was first reported by Dahl in the 1940s. It was followed by a more comprehensive report by Goldberg and Gershkoff, who published the first case series in the United States. We describe a case of an orocutaneous fistula that developed secondary to a chronic infection attributed to a failing subperiosteal implant. Elemental analysis of the metal framework revealed an implant composed of mainly a cobalt-chromium alloy. Cobalt, which was frequently used in subperiosteal implant manufacturing, is associated with a higher corrosion rate than other metals and is no longer used to fabricate subperiosteal implants. The strength of subperiosteal implants is their ability to be used in a mandible with an atrophic alveolar ridge. Unfortunately, this feature of the hardware is also its weakness in that reconstructive procedures after their removal are difficult. The failing subperiosteal implant in our patient was subsequently removed, and primary closure of the intraoral wound and extraoral fistula as well as resolution of the patient's symptoms was obtained with no lasting complications.
authors.affiliation: University at Buffalo, School of Dental Medicine, Buffalo, NY, USA. michaelmarkiewicz@gmail.com
authors.forename: Michael R
authors.initials: MR
authors.lastname: Markiewicz
authors.forename: Kazuhide
authors.initials: K
authors.lastname: Nishiyama
authors.forename: Kaori
authors.initials: K
authors.lastname: Yago
authors.forename: Meiko
authors.initials: M
authors.lastname: Okada
authors.forename: Soichiro
authors.initials: S
authors.lastname: Asanami
authors.forename: Masao
authors.initials: M
authors.lastname: Yoshinari
authors.forename: Muneki
authors.initials: M
authors.lastname: Hirayama
authors.forename: Joseph E
authors.initials: JE
authors.lastname: Margarone
authors.forename: Sung-Kiang
authors.initials: SK
authors.lastname: Chuang
mesh_terms: D002858:Chromium Alloys / Q000009:adverse effects; D003035:Cobalt / Q000009:adverse effects; D003343:Corrosion; D017577:Cutaneous Fistula / Q000209:etiology*; D003751:Dental Fistula / Q000000981:diagnostic imaging / Q000209:etiology* / Q000628:therapy; D003758:Dental Implantation, Endosseous / Q000009:adverse effects*; D015921:Dental Implants / Q000009:adverse effects*; D019232:Dental Restoration Failure; D004487:Edema / Q000209:etiology; D005260:Female; D006801:Humans; D008875:Middle Aged; D011859:Radiography
chemical_list: D002858:Chromium Alloys; D015921:Dental Implants; D003035:Cobalt