Displacement of dental implants into the focal osteoporotic bone marrow defect: a report of three cases
A 51-year-old woman with no medical history was referred by a private dental clinic for the management of displacement of implant fixture in the right mandible posterior area on November 7, 2011. Two days earlier, an implant accidentally fell into the mandible body of the #46 area during implant surgery. She complained of hypoesthesia on the right lower lip and chin area. Cone-beam computed tomography (CBCT) imaging of the jaws showed 2.0×0.7 cm radiolucency with quite ill-defined and irregular borders located from the premolar area to the right midbody of the #46, #47 edentulous regions and indicated the implant location to be near the mandibular inferior border area.() Block anesthesia of the right mandibular nerve was administered together with infiltration anesthesia of the surrounding tissues. A mucoperiosteal flap was raised, and a periosteal elevator was placed under the periosteum. Bone osteotomy (1.0×0.5 cm) was performed at the lateral corpus of the mandible with fissure bur and osteotomes. A rectangular cortical bone window was removed. The implant (4.0 mm wide, 8.0 mm long) was exposed and carefully removed without any damage to the mandibular neurovascular bundle. The inner side of the corpus was empty, without any cancellous bone. The osteotomy window was put back to its original position without fixation. The mucoperiosteal flap was replaced and sutured. Postoperatively, a 5-day course of amoxicillin and chlorhexidine rinse was prescribed. The sutures were removed 7 days postoperatively. She complained of hypoesthesia of the right lower lip and chin area during the 9 months' follow-up.()