Atraumatic Removal of Displaced Implant in the Fatty Bony Marrow

Abstract

A 53-year-old Korean female was referred to the Department of Oral and Maxillofacial Surgery at the Seoul National University Dental Hospital. The patient’s chief complaint and concern involved the occasional feeling of discomfort and pain in the region of the lower right second molar. Panoramic radiograph revealed a #47 implant fixture that was dislocated horizontally deep in the fatty degenerated area of the posterior mandible. A rare case of implant displacement into the fatty degenerated area of the posterior mandible caused inferior alveolar nerve (IAN) compression. Fatty degeneration is a condition that occurs in mostly elderly female patients due to aging and is inevitable. We recommend accurate preoperative evaluation using radiographic imaging techniques such as computer tomography and histopathological analysis for differential diagnosis. Endoscopic intraoperative examinations can reduce the invasiveness of the surgery and provide accuracy in examining the intactness of the IAN. This case report suggests the efficacy of the selected method of treatment and, the removal of the displaced implant and decompression of the IAN using endoscopic visualization followed by 8 months of healing and two-stage implant installation with guided bone regeneration in cases of related implant complications.