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Dental implantation has become an important procedure for both dental treatment and head and neck reconstructive surgery. However, this useful technique sometimes results in peri-implantitis. We describe a rare complication of peri-implantitis in the maxilla which extended to the soft tissue and caused an extra-oral fistula above the alar region. The patient underwent the placement of dental implants in the maxilla 8 years earlier. Radiography showed osteolysis of the maxilla and implant exposure. After the implants were removed, the patient was fitted with a conventional fixed partial denture. Such unfavorable outcomes are caused by failed endodontic and apicoectomy procedures.
Key Words: extra-oral fistulae, dental implant, implant-associated periapical lesions, periimplantitis
INTRODUCTION
Dental implantation has become an important procedure for both dental treatment and head and neck reconstructive surgery.1 However, this useful technique sometimes results in peri-implantitis, of which chronic inflammation usually causes osteolysis around the implant.2 Many investigators have evaluated clinical and microscopic features of implantassociated periapical lesions, and the types of complication assessed were as follows: implant loss, sensory disturbance, soft tissue complications, peri-implantitis, bone loss, and implant fracture.3-4
We present a rare case of peri-implantitis due to implant-associated periapical lesions of the maxilla, which extended to the soft tissue and resulted in an extra-oral fistula.
CASE REPORT
A 72-year-old woman consulted the Department of Plastic and Reconstructive Surgery of our hospital complaining of a facial fistula of 6 months duration. On examination, a 2.0 3 1.5-cm skin fistula was found in the maxilla above the alar region. The skin around the fistula...