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Displacement of Dental Implant Body into Oral Soft Tissues: A Case Report

Kazumasa Yoshida, DDS, PhD – Associate Professor, Department of Oral & Maxillofacial Surgery, Nippon Dental University Hospital

Hirobumi Shoji, DDS, PhD – Associate Professor, Department of Oral & Maxillofacial Surgery, Nippon Dental University Hospital

Abstract:

Purpose of the Study: Dental implant displacement into the maxillary sinus has occasionally been reported; however, dental implant displacement into oral soft tissues is rare. We report a case of dental implant displacement into the buccal mucosa and some discussion.

Methods: Case: The patient was a 62-year-old man. First Visit: March 2010 History of Presenting Illness: Dental implantation was performed for the maxillary left second molar at a private dental clinic in November 2009. The patient suffered from persistent discomfort in the left buccal area and visited another doctor who referred him to our hospital in February 2010. The X-ray showed a metallic radiopacity in the retromolar area of the left side of the mandible. The patient was referred to our hospital. Local Findings: A removable solid body was felt around the orifice of the parotid duct inside the left buccal mucosa. Imaging: Computed tomography revealed a metallic radiopacity present subcutaneously in the left buccal area outside of the masseter muscle in two places at the level of the mandibular foramen.

Results: Treatment and Course: Under general anesthesia, an oral surgeon detected the positions of the implant body using an implant detector, which was developed as a metallic detector for implant treatments. An operator made an incision from the maxillary gingivobuccal fold to the buccal mucosa and flapped deeply and bluntly into the tissues beneath the buccal mucosa. Subsequently, an implant cover screw and an implant body were removed from the buccal fat pad.

Conclusion: As mild-to-moderate trismus developed after the implant placement, we suspected implant displacement. The displacement may be because of the insertion of the implant in a wrong direction, sliding the implant body to the buccal side, penetrating deeply into the buccinator space through the tissues beneath the buccal mucosa and buccinator, and reaching the anterior border of the masseter muscle through the buccal fat pad. When foreign bodies are removed from the oral soft tissues, identification of the position is difficult; therefore, the implant detector was useful for second stage implant surgery. We encountered a case of dental implant displacement into the oral soft tissues. Therefore, we believe that improved skills are required to perform careful and safe dental implant surgery.

Articles: 1. Bibra A, Mahajan S, Dhawan R. Retrieval of dental implant displaced into buccal space: A rare case report. IJOICR. 2016; 7: 17−19. 2. Shoji H, Adachi M, Yoshida K, Shibata A, Hasegawa I, Shirakawa M. Clinical study of accidental displacement of dental implant into maxillary sinus. Hosp Dent Oral-Maxillofac Surg. 21: 13−14, 2009. 3. Gnigou M, Goutzanis L, Sarivalasis S, Petsinis V. Retrieval of displaced implants inside the maxillary sinus: Two case reports and a short review. Int J Implant Dent. 2019; 5. doi.org/10.1186/s40729-019-0173-7.


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