Dental implant failure associated with bacterial infection and long-term bisphosphonate usage:  a case report.
Although the risk of developing osteonecrosis of the jaw for oral implants in patients using oral bisphosphonates (BPs) is low, the devastating complications still require caution. We document a case of severe periimplant infection that developed after the patient had used oral BPs for 3 years. Exposed bone and osteonecrosis persisted for more than 2 months after 1 infected implant was explanted by a dentist unaware that the patient was taking BPs. After oral BPs had been stopped, another involved implant was explanted, sequestra were removed, a primary closure was sutured, and the antibiotic was changed; then the wound was finally under control. The explanted implant with attached bone was processed for undecalcified ground sections, and specimens from the bony lesion were sent to pathology for examination. Osteonecrosis, severe inflammatory osteolysis, and heavy bacterial colonization were found. Patients at risk must be alerted about the potential risks of implant failure and developing BP-related osteonecrosis of the jaw.
Institute of Oral Medicine, Department of Oral Medicine, National Cheng Kung University Hospital, Tainan, Taiwan. kuoyuan@mail.ncku.edu.tw
Kuo
K
Yuan
Ken-Chung
KC
Chen
Ying-Jen
YJ
Chan
Chun-Chun
CC
Tsai
Hui-Hwa
HH
Chen
Chien-Chi
CC
Shih
D000368:Aged; D019980:Amoxicillin-Potassium Clavulanate Combination / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D059266:Bisphosphonate-Associated Osteonecrosis of the Jaw / Q000150:complications* / Q000601:surgery; D015921:Dental Implants / Q000009:adverse effects / Q000382:microbiology*; D019232:Dental Restoration Failure; D020878:Device Removal; D005674:Fusobacterium Infections / Q000150:complications / Q000188:drug therapy; D006801:Humans; D008297:Male; D057873:Peri-Implantitis / Q000209:etiology* / Q000382:microbiology / Q000601:surgery; D016459:Prosthesis-Related Infections / Q000150:complications* / Q000188:drug therapy / Q000601:surgery; D013290:Streptococcal Infections / Q000150:complications / Q000188:drug therapy; D034363:Viridans Streptococci
D000900:Anti-Bacterial Agents; D015921:Dental Implants; D019980:Amoxicillin-Potassium Clavulanate Combination