title: Mandibular osteomyelitis associated with dental implants. A case series.
abstract: OBJECTIVE
  To present a series of rare and serious complications associated with endosseous implant therapy.
  
  
  METHODS
  Five cases of mandibular osteomyelitis emerging in dental implant insertion sites are presented. In three cases, the clinical signs and symptoms of osteomyelitis occurred almost immediately following implant insertion. All cases occurred in patients with stable pre-existing medical conditions. Three of the patients were females and two were males, all of whom were in their sixth and seventh decades of life.
  
  
  RESULTS
  Clinical symptoms such as pain and local infection were observed in all cases, despite long-term antibiotic treatment. All cases underwent progressive surgical treatment including corticotomy, saucerization, sequestrectomy and drainage. Two cases exhibited spreading of bone infection in the mandible which required segmental mandibulectomy and fixation using reconstruction plates. The symptom-free state was only achieved following surgical intervention and antibiotic treatment in four patients. A minimal follow-up of 1 year revealed complete resolution of the infection and symptoms in four out of five patients. The outcome of the fifth patient is unknown.
  
  
  CONCLUSIONS
  Osteomyelitis related to dental implants is a rare and serious complication. Prolonged antibiotics at high dosage together with aggressive surgical treatment is required. Increasing the awareness among dental surgeons and maintaining correct surgical principles are essential in order to reduce the risk of osteomyelitis. Conflict of interest statement: We have no conflict of interests to report.
authors.forename: Gabriel
authors.initials: G
authors.lastname: Semel
authors.forename: Amir
authors.initials: A
authors.lastname: Wolff
authors.forename: Dekel
authors.initials: D
authors.lastname: Shilo
authors.forename: Sharon
authors.initials: S
authors.lastname: Akrish
authors.forename: Omri
authors.initials: O
authors.lastname: Emodi
authors.forename: Adi
authors.initials: A
authors.lastname: Rachmiel
mesh_terms: D000368:Aged; D015921:Dental Implants / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D008336:Mandibular Diseases / Q000209:etiology*; D008875:Middle Aged; D010019:Osteomyelitis / Q000209:etiology*; D012189:Retrospective Studies
chemical_list: D015921:Dental Implants