Accidental displacement of a dental implant into the sublingual space: A Case report
Identifieur interne : 001D72 ( Pmc/Corpus ); précédent : 001D71; suivant : 001D73Accidental displacement of a dental implant into the sublingual space: A Case report
Auteurs : Paolo Cariati ; José Fernández-Solís ; Ana-Belén Marín-Fernández ; Alfredo Valencia-Laseca ; Fernando Monsalve-IglesiasSource :
- Journal of Clinical and Experimental Dentistry [ 1989-5488 ] ; 2016.
Abstract
Dental implant surgery is continuously expanding. In fact, every day more and more surgeons are choosing dental implants for allowing great results in the field of oral rehabilitation. However, these procedures are not exempt from complications. This report presents the case of a 66 years old man underwent implant surgery by a specialized dentist. No problems were reported during implant placement. Despite this, three months later, it was displaced into the sublingual space at the time of uncovering. Against this backdrop, the patient was referred to an expert maxillofacial surgeon. Next day, the implant was removed using an intraoral approach to reach the sublingual space. According with our knowledge, there are no cases reported in the literature that describe this complication.
Url:
DOI: 10.4317/jced.52994
PubMed: 27703616
PubMed Central: 5045695
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<author><name sortKey="Cariati, Paolo" sort="Cariati, Paolo" uniqKey="Cariati P" first="Paolo" last="Cariati">Paolo Cariati</name>
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<author><name sortKey="Fernandez Solis, Jose" sort="Fernandez Solis, Jose" uniqKey="Fernandez Solis J" first="José" last="Fernández-Solís">José Fernández-Solís</name>
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<author><name sortKey="Marin Fernandez, Ana Belen" sort="Marin Fernandez, Ana Belen" uniqKey="Marin Fernandez A" first="Ana-Belén" last="Marín-Fernández">Ana-Belén Marín-Fernández</name>
<affiliation><nlm:aff id="A2">Maxillofacial Surgeon. Hospital Universitario Virgen de las nieves, Granada, Spain</nlm:aff>
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<author><name sortKey="Valencia Laseca, Alfredo" sort="Valencia Laseca, Alfredo" uniqKey="Valencia Laseca A" first="Alfredo" last="Valencia-Laseca">Alfredo Valencia-Laseca</name>
<affiliation><nlm:aff id="A1">Oral and Maxillofacial surgery resident. Hospital Universitario Virgen de las nieves, Granada, Spain</nlm:aff>
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<author><name sortKey="Monsalve Iglesias, Fernando" sort="Monsalve Iglesias, Fernando" uniqKey="Monsalve Iglesias F" first="Fernando" last="Monsalve-Iglesias">Fernando Monsalve-Iglesias</name>
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<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Accidental displacement of a dental implant
into the sublingual space: A Case report</title>
<author><name sortKey="Cariati, Paolo" sort="Cariati, Paolo" uniqKey="Cariati P" first="Paolo" last="Cariati">Paolo Cariati</name>
<affiliation><nlm:aff id="A1">Oral and Maxillofacial surgery resident. Hospital Universitario Virgen de las nieves, Granada, Spain</nlm:aff>
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<author><name sortKey="Fernandez Solis, Jose" sort="Fernandez Solis, Jose" uniqKey="Fernandez Solis J" first="José" last="Fernández-Solís">José Fernández-Solís</name>
<affiliation><nlm:aff id="A2">Maxillofacial Surgeon. Hospital Universitario Virgen de las nieves, Granada, Spain</nlm:aff>
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<author><name sortKey="Marin Fernandez, Ana Belen" sort="Marin Fernandez, Ana Belen" uniqKey="Marin Fernandez A" first="Ana-Belén" last="Marín-Fernández">Ana-Belén Marín-Fernández</name>
<affiliation><nlm:aff id="A2">Maxillofacial Surgeon. Hospital Universitario Virgen de las nieves, Granada, Spain</nlm:aff>
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<author><name sortKey="Valencia Laseca, Alfredo" sort="Valencia Laseca, Alfredo" uniqKey="Valencia Laseca A" first="Alfredo" last="Valencia-Laseca">Alfredo Valencia-Laseca</name>
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<author><name sortKey="Monsalve Iglesias, Fernando" sort="Monsalve Iglesias, Fernando" uniqKey="Monsalve Iglesias F" first="Fernando" last="Monsalve-Iglesias">Fernando Monsalve-Iglesias</name>
<affiliation><nlm:aff id="A1">Oral and Maxillofacial surgery resident. Hospital Universitario Virgen de las nieves, Granada, Spain</nlm:aff>
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<series><title level="j">Journal of Clinical and Experimental Dentistry</title>
<idno type="eISSN">1989-5488</idno>
<imprint><date when="2016">2016</date>
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<front><div type="abstract" xml:lang="en"><p>Dental implant surgery is continuously expanding. In fact, every day more and more surgeons are choosing dental implants for allowing great results in the field of oral rehabilitation. However, these procedures are not exempt from complications. This report presents the case of a 66 years old man underwent implant surgery by a specialized dentist. No problems were reported during implant placement. Despite this, three months later, it was displaced into the sublingual space at the time of uncovering. Against this backdrop, the patient was referred to an expert maxillofacial surgeon. Next day, the implant was removed using an intraoral approach to reach the sublingual space. According with our knowledge, there are no cases reported in the literature that describe this complication.
</p>
<p><bold> Key words:</bold>
Dental implant, sublingual space, bone atrophy, complications of oral surgery.</p>
</div>
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<pmc article-type="case-report"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">J Clin Exp Dent</journal-id>
<journal-id journal-id-type="iso-abbrev">J Clin Exp Dent</journal-id>
<journal-id journal-id-type="publisher-id">Medicina Oral S.L.</journal-id>
<journal-title-group><journal-title>Journal of Clinical and Experimental Dentistry</journal-title>
</journal-title-group>
<issn pub-type="epub">1989-5488</issn>
<publisher><publisher-name>Medicina Oral S.L.</publisher-name>
</publisher>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">27703616</article-id>
<article-id pub-id-type="pmc">5045695</article-id>
<article-id pub-id-type="publisher-id">52994</article-id>
<article-id pub-id-type="doi">10.4317/jced.52994</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Case Report</subject>
<subj-group><subject>Implantology</subject>
</subj-group>
</subj-group>
</article-categories>
<title-group><article-title>Accidental displacement of a dental implant
into the sublingual space: A Case report</article-title>
</title-group>
<contrib-group><contrib contrib-type="author" corresp="yes"><name><surname>Cariati</surname>
<given-names>Paolo</given-names>
</name>
<xref ref-type="aff" rid="A1">1</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Fernández-Solís</surname>
<given-names>José</given-names>
</name>
<xref ref-type="aff" rid="A2">2</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Marín-Fernández</surname>
<given-names>Ana-Belén</given-names>
</name>
<xref ref-type="aff" rid="A2">2</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Valencia-Laseca</surname>
<given-names>Alfredo</given-names>
</name>
<xref ref-type="aff" rid="A1">1</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Monsalve-Iglesias</surname>
<given-names>Fernando</given-names>
</name>
<xref ref-type="aff" rid="A1">1</xref>
</contrib>
</contrib-group>
<aff id="A1"><label>1</label>
Oral and Maxillofacial surgery resident. Hospital Universitario Virgen de las nieves, Granada, Spain</aff>
<aff id="A2"><label>2</label>
Maxillofacial Surgeon. Hospital Universitario Virgen de las nieves, Granada, Spain</aff>
<author-notes><corresp> Hospital de Rehabilitación y Traumatología
Servicio de Cirugía Oral y Maxilofacial
Carretera de Jaén s/n, 18013
Granada, Spain
, E-mail: <email>paolocariati1@gmail.com</email>
</corresp>
<fn id="FN1" fn-type="COI-statement"><p><bold>Conflict of interest statement:</bold>
The authors have declared that no conflict of interest exist.</p>
</fn>
</author-notes>
<pub-date pub-type="epub"><day>1</day>
<month>10</month>
<year>2016</year>
</pub-date>
<pub-date pub-type="collection"><month>10</month>
<year>2016</year>
</pub-date>
<volume>8</volume>
<issue>4</issue>
<fpage>e459</fpage>
<lpage>e461</lpage>
<history><date date-type="accepted"><day>10</day>
<month>2</month>
<year>2016</year>
</date>
<date date-type="received"><day>23</day>
<month>1</month>
<year>2016</year>
</date>
</history>
<permissions><copyright-statement>Copyright: © 2016 Medicina Oral S.L.</copyright-statement>
<copyright-year>2016</copyright-year>
<license license-type="open-access" xlink:href="http://creativecommons.org/licenses/by/2.5/"><license-p>This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</license-p>
</license>
</permissions>
<abstract><p>Dental implant surgery is continuously expanding. In fact, every day more and more surgeons are choosing dental implants for allowing great results in the field of oral rehabilitation. However, these procedures are not exempt from complications. This report presents the case of a 66 years old man underwent implant surgery by a specialized dentist. No problems were reported during implant placement. Despite this, three months later, it was displaced into the sublingual space at the time of uncovering. Against this backdrop, the patient was referred to an expert maxillofacial surgeon. Next day, the implant was removed using an intraoral approach to reach the sublingual space. According with our knowledge, there are no cases reported in the literature that describe this complication.
</p>
<p><bold> Key words:</bold>
Dental implant, sublingual space, bone atrophy, complications of oral surgery.</p>
</abstract>
</article-meta>
</front>
<body><sec><title>Introduction</title>
<p>The use of dental implant for rehabilitating an edentulous jaw is a common practice (<xref rid="B1" ref-type="bibr">1</xref>
). The most frequent complications of implant surgery are infection, implant rejection, implant migration and implant rupture (<xref rid="B2" ref-type="bibr">2</xref>
,<xref rid="B3" ref-type="bibr">3</xref>
). Interestingly, implant displacement into the maxillary sinus is not an uncommon complication encountered in oral surgery (<xref rid="B4" ref-type="bibr">4</xref>
,<xref rid="B5" ref-type="bibr">5</xref>
). Nevertheless, the implant migration into the sublingual space is a complication not reported in the literature. In this line, the displacement of foreign body into this anatomical space might provoke serious complications (<xref rid="B6" ref-type="bibr">6</xref>
). In fact, it could cause a major infection (<xref rid="B7" ref-type="bibr">7</xref>
). The aim of the present report is twofold. First, we examine the importance of the proper management of these cases. Second, we describe this rare case with the goal of proposing suitable treatments. Furthermore, we present the radiographic images that were used to locate the implant.</p>
</sec>
<sec><title>Case Report</title>
<p>We describe the case of a 66-year-old man who underwent implant surgery by a specialized dentist. The aim of surgery was to place a dental implant in the fourth quadrant of the jaw. Is important to note that the patient presented a severe bone atrophy in this sector. No problems were reported during the implant placement. Notwithstanding, few months later, the implant migrated into the sublingual space during the uncovering phase. In light of these facts, the patient was immediately referred to emergency service. Once in the hospital, intravenous antibiotic treatment was administered and a maxillofacial surgeon was contacted. After a careful examinations of the case we decide to remove the implant under general anesthesia and with intraoral approach. The surgery was successful and the patient was discharged from the hospital the day after the procedure, (Figs. <xref ref-type="fig" rid="F1">1</xref>
-<xref ref-type="fig" rid="F3">3</xref>
).</p>
<p><fig id="F1" orientation="portrait" position="float"><label>Figure 1</label>
<caption><p>CT images of implant displacement.</p>
</caption>
<graphic xlink:href="jced-8-e459-g001"></graphic>
</fig>
</p>
<p><fig id="F2" orientation="portrait" position="float"><label>Figure 2</label>
<caption><p>Implant position showed by 3D-reconstruction.</p>
</caption>
<graphic xlink:href="jced-8-e459-g002"></graphic>
</fig>
</p>
<p><fig id="F3" orientation="portrait" position="float"><label>Figure 3</label>
<caption><p>Implant displacement into sublingual space. Side view face X-ray.</p>
</caption>
<graphic xlink:href="jced-8-e459-g003"></graphic>
</fig>
</p>
</sec>
<sec><title>Discussion</title>
<p>The Displacement of a dental implant into the sublingual space is a rare complication of implant surgery. To our knowledge, there no other cases reported in the literature. Regarding the surgical aspects, the present research focused on the importance of a correct management of these cases. Specifically, it is necessary to hospitalize the patient. In fact, is imperative to avoid any manipulation of the sublingual space outside of an operating room. Secondly, the hospitalization is necessary in order to begin an early intravenous antibiotic treatment. Finally, the surgical removal of the implant might be carried out as soon as possible. In fact, the presence of a foreign body into the sublingual space could provoke serious problems. Moreover, we would like to analyze the possible production mechanism of this complication. In fact, the surgical exploration of the patient revealed the presence of a drilling in the inner side of the jaw bone. In view of that, we firmly believe that the implant displacement was caused by the reabsorption of the internal jaw cortical (<xref rid="B8" ref-type="bibr">8</xref>
). In this sense, we opine that the implant position was initially not adequate to permit the request osseointegration (<xref rid="B9" ref-type="bibr">9</xref>
). The reason for this is that during the first surgery the implant was severely medially inserted. Consequently, the lack of primary implant stability is the major cause of this complication. Concluding, we would to stress that this report contains two points that are central to us: firstly, numerous variables have to be considered before the beginning of each implant surgery. Specifically, the level of bone atrophy is perhaps the most important parameter. Secondly, we would to stress that the obtaining of great results in advanced dental rehabilitation programs is not a simple task. In this line, we highlight that only expert professionals can effectively perform these procedures.</p>
</sec>
</body>
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