Successful Management of Ludwig's Angina due to Dental Implant Displacement: A Rare Case Report

Abstract

Dental implant surgery is a common procedure in oral and maxillofacial surgery practices. Extensive training, skill, and experience allow this procedure to be performed with an atraumatic approach, but like any surgical technique, it is subject to accidents and complications. This is an unusual clinical case of an accidental displacement of an implant into the submandibular space that progressed to Ludwig's angina, and it has not yet been described in the literature. This case report describes a clinical case of dental implant displaced into the submandibular space after healing cap removal. After seven days, it progressed to Ludwig's angina. The removal was performed through extraoral access in the submandibular area by using hemostatic forceps and radioscopic technique. After implant removal, the clinical case showed a satisfactory repair emphasizing the importance of a meticulous clinical planning to achieve an appropriate treatment plan, which is essential for a favorable prognosis. Therefore, prevention and management of displaced objects requires proper planning and surgical technique.

Figure 1

(a) Panoramic radiographic image. (b) Cone beam computed tomographs in sagittal sections showing displacement of the dental implant and fracture of the mandibular lingual cortical bone adjacent to the region of tooth #36.

Figure 2

(a) Clinical aspect of the Ludwig's angina. (b) Arrow shows anterior neck edema. (c) Reduced mouth opening.

Figure 3

(a) X-ray profile showing location of the dental implant in the submandibular region. (b) X-ray showing clamping and removal of the dental implant.

Figure 4

Postoperative panoramic radiograph without other complaints after 7 days.