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Quintessence Publishing: Journals: EJOI

 

European Journal of Oral Implantology

Editor in Chief: Dr. Marco Esposito

Official publication of the British Society of Oral Implantology (BSOI) and the Dutch Society of Oral Implantology (NVOI)

ISSN (print) 1756-2406 • ISSN (online) 1756-2414

Publication:

Winter 2012
Volume 5 , Issue 4

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Severe descending mediastinitis after routine dental implant surgery: a case report

Capecchi, Marco / Buongiorno, Valerio / Romagnoli, Andrea / Parri, Sergio Nicola Forti / Guiducci, Gian Marco / Bressan, Eriberto

Pages: 389 - 396
PMID: 23304692

Purpose: The aim of this article is to present a clinical case of severe descending mediastinitis following the insertion of three dental implants in the mandible.
Materials and methods: A 64-year-old female was treated with an implant-supported rehabilitation for her mandibular missing teeth in positions 36, 45 and 46.
Results: Three days after the dental implant surgery, the patient complained of malaise, shiver and fever (38C) with dysphagia and swelling of the mouth floor. The following day the patient was admitted to the hospital with a diagnosis of larynx oedema. Due to the worsening clinical conditions on day 5, she was transferred to the Thoracic Surgery Division with a diagnosis of left neck phlegmon and underwent cervicotomy. A CT scan at day 9 showed mediastinal extension of the phlegmon with initial pleural reaction. The patient then underwent cervicotomy again for drainage. On day 16, she underwent videothoracoscopy to drain a left pleural effusion. The patient was discharged on day 31.
Conclusions: Despite the fact that descending mediastinitis has a very high mortality rate, in the present case proper treatment was able to resolve this serious complication. It is likely that the early diagnosis and prompt treatment prevented neck and mediastinal infection diffusion. Clinicians should always keep in mind that a potential fatal infection complication may arise after routine dental implant surgery in the mandible.

Keywords: complication, dental implants, infection, mediastinitis

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