Discussion
This case highlights a complicated course following augmentation
genioplasty ultimately requiring implant removal. A fracture of tooth
#27 was found to be the culprit, but this was not evident on oral
examination, dental evaluation, CT scan, and two surgical explorations.
Only two reports exist in the literature describing odontogenic
infection with direct extension to an alloplastic chin
implant3,4. In both cases, the implant was
removed3,4. Although a rare problem, the associated
morbidity of surgical site infection, adverse antibiotic reactions and
resistance, and surgical failure are significant. We suggest
comprehensive preoperative dental evaluation prior to augmentation
genioplasty with an alloplastic implant. Osseous genioplasty may be
considered as an alternative given lower reported infection rates and
morbidity1.