Chronic Refractory Osteomyelitis of the Mandible and Maxilla Related to Dental Implant Placement

A 68-year-old diabetic woman with chronic refractory osteomyelitis involving the mandible and maxilla following dental implant placement is presented. The inflammatory lesion showed actinomycotic findings histopathologically and refractory responses to several surgical and medical treatments for over 2 years. A periapical lesion on an adjacent tooth was overlooked as a possible source of infection. The lesion was cured after complete surgical debridement in combination with long-term antibiotic therapy.