title: Histopathological spectrum of bone lesions associated with dental implant failure: osteomyelitis and beyond.
abstract: Early or late post-implant placement complications are usually localized infectious/inflammatory processes and treated accordingly. If the healing process does not take place within a reasonable timeframe, the possibility of a pathologic process beyond localized infection/inflammation should be suspected. We describe a radiological/histopathological spectrum of bony lesions ranging from inflammatory to malignant lesions surrounding failed dental implants. Five cases of mandibular dental implant failure that clinically, radiologically and histopathologically appeared to be inflammatory processes are presented. The failure of the dental implants was immediate in two cases and late in the remaining three. The radiological features were essentially similar for all five, and they included radiolucent or mixed radiolucent-radiopaque lesions with poorly defined borders. Three lesions were limited to the area of the failed implant, while the other two extended to a large part of the mandible. The histopathological findings ranged from acute osteomyelitis and chronic osteomyelitis with features of a fibro-osseous-like lesion and occasional rimming of atypical osteoblasts to osteogenic sarcoma that was admixed with a component of osteomyelitis (diagnosis of the latter was achieved only after a series of biopsies). In-depth investigative procedures are imperative in order to establish an accurate diagnosis whenever the histopathological diagnosis is inconsistent with persisting clinical signs and symptoms in bone lesions associated with failed dental implants.
authors.affiliation: Department of Oral Pathology and Oral Medicine, School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Anna
authors.initials: A
authors.lastname: Shnaiderman-Shapiro
authors.forename: Dan
authors.initials: D
authors.lastname: Dayan
authors.forename: Amos
authors.initials: A
authors.lastname: Buchner
authors.forename: Ignat
authors.initials: I
authors.lastname: Schwartz
authors.forename: Ran
authors.initials: R
authors.lastname: Yahalom
authors.forename: Marilena
authors.initials: M
authors.lastname: Vered
mesh_terms: D000368:Aged; D001859:Bone Neoplasms / Q000209:etiology* / Q000473:pathology; D015921:Dental Implants / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D008336:Mandibular Diseases / Q000209:etiology* / Q000473:pathology; D008875:Middle Aged; D010019:Osteomyelitis / Q000209:etiology* / Q000473:pathology; D012516:Osteosarcoma / Q000209:etiology* / Q000473:pathology
chemical_list: D015921:Dental Implants