Mandibular osteomyelitis due to dental implants is a rare and serious condition. After a month of removing the implants and antibiotic medication, the infection continues. Is decortication of the affected bone and antibiotic flushing a predictable treatment?
Depending on the previous antibiotic medication and the local resistance rates, a carbapenem with a fluorquinolone may be a good choice.
Antibiotic sensitivity test will guide us to the best type and dose of the antibiotic.
Taking swab from oral cavity is prone to contamination by oral flora, taking piece of infected tissue ( curetage the area ) may be more accurate.
If there is radiographic signs of sequestrum, it is better to be removed.
Keep in mind the importance of systemic condition ( anemia, poorly controlled diabetes, vitamin D deficiency)
The fact that the infection is not definitively solved may not be associated only with the type of antibiotic used. Depending on the cause of osteomyelitis, no antibiotic alone may solve the infection.
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