An implant periapical lesion leading to acute osteomyelitis with isolation of Staphylococcus aureus

A case of an implant periapical lesion (IPL) proceeding to acute osteomyelitis is presented, most likely due to surface contamination of the implant. Five weeks post placement of two anterior mandibular implants, symptoms of acute pain from one implant presented. This symptom and later swelling were unresponsive to antibiotics. On removal of the implant, there was a purulent discharge which, following microbial analysis, proved to be a pure growth of Staphylococcus aureus. A replacement implant was positioned in the site of the previously lost implant ten weeks later, with no recurrence of infection. Staphylococcus aureus can be isolated commonly from the mouths of denture wearers. When an IPL affects a recently placed implant its removal should be accepted but its replacement also considered.