Mandibular osteomyelitis after hyaluronic acid injection

Background Mandibular osteomyelitis after filler injection is extremely rare. Aims We reported a case of mandibular osteomyelitis after hyaluronic acid injection. Patients A 33-year-old woman received 1 mL hyaluronic acid injection on her chin 1 year ago, after which her chin kept swelling and painful, and gradually ulcerated with pus flowing out. She received antibiotics, debridement procedures, negative pressure wound therapy, and hyperbaric oxygen therapy without symptoms improved. Cone-beam computed tomography scan showed local bone destruction, sequestrum formation, and tissue calcification on the right mandible body. The patient was diagnosed with mandibular osteomyelitis and received local curettage for the removal of necrotized bone. Results Literature search found no case reports on mandibular osteomyelitis after filler injection so far. Conclusion Minimizing the risk of contamination and infection is strictly required during the filler injection process. Once the patient shows signs of incurable mandibular infection postoperation, clinicians should consider the possibility of osteomyelitis.