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.