Abstract
We experienced a case of refracture during implant treatment after open reduction of mandibular fracture followed by distraction osteogenesis. A male in his thirties who had a craniofacial fracture and fracture in the symphyseal region of the mandible was treated with osteosynthesis plates by a neurosurgeon, plastic surgeon and oral and maxillofacial surgeon. One year after the initial surgery, alveolar augmentation by distraction osteogenesis was performed to compensate for the loss of alveolar bone and mucosa at the anterior region of the mandible. Two implants were inserted 3 months later but one failed to integrate 3 months after insertion and the reason for disintegration was unknown. Six months after insertion, panoramic radiograph showed a fracture of the mini-plate, which was reinforced to prevent fracture of the mandible during distraction osteogenesis. Computed tomography (CT) imaging was performed to access the mandible after two consecutive failures of implant insertions and revealed a fracture adjacent to the implants. The cause of failure was therefore identified to be the micromovement caused by mandibular fracture. Osteosynthesis of the refracture region was performed with successful implants inserted thereafter. Inadequate monitoring of the cause of failure may prolong the treatment period and lead to unsuccessful implant insertion.
