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Implant Related MRONJ ? A Case of Partial Mandibulectomy in the Medically Compromised Elderly Patient

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Á¤ÂùÈ£ ( Jung Chan-Ho ) - Inje University College of Medicine Inje University Sanggye Paik Hospital Department of Oral and Maxillofacial Surgery
¹Ú°ü¼ö ( Park Kwan-Soo ) - Inje University College of Medicine Sanggye Paik Hospital Department of Oral and Maxillofacial Surgery

Abstract


The aim of this case report is to present the possibility of development of osteonecrosis around implant under load in a patient taking antiresorptive agent. A 78-year-old female complained of the mobility of implants and the swelling on left submandibular area. The patient was taking alendronate for the treatment of osteoporosis during 28 months. The implants were placed and functioned long before the patient received alendronate. Pus discharge and gingival swelling were observed on peri-implant area. Alveolar bone loss was seen on the radiograph. Curettage was performed and the antiresorptive agent was discontinued. Five months later, the patient revisited with swelling and new fistula formation on left submandibular area. On the radiograph, sequestrae and fracture line were seen around peri-implant area. Supportive care was performed for general anesthesia surgery. Partial mandibulectomy was performed, the result of the surgery was good and the reconstruction metal plate is maintained well.

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Dental implant; Implantitis; Medication-related osteonecrosis of the jaw; Partial mandibulectomy

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