Only few cases of the focal osteoporotic bone marrow defect associated with dental implants has been described in the English literature. Sençimen et al. (2011) reported a clinical case in which the focal osteoporotic bone marrow defect occurred 2 years postoperatively apical to a dental implant in posterior mandible region and the diagnosis was established based on the combination of clinical, radiographic, and microscopic features. Posteriorly, Lee et al. (2013) reported three clinical cases of displacement of dental implants into the focal osteoporotic bone marrow defect, but the final diagnoses of this condition were based only on clinical and radiographic findings. In this paper, we described a case of the focal osteoporotic bone marrow defect associated to dental implant which was diagnosed by histopathological analysis.

Microscopically, the presence of hematopoietic marrow composed of monocytic, erythroid, granulocytic, and lymphocytic series as well as megakaryocytes associated with fatty marrow is required for diagnosis of focal osteoporotic bone marrow defect.

In the present case the final diagnosis was established based on the combination of radiographic and microscopic features. Some authors have based the focal osteoporotic bone marrow defect diagnosis on age, site, and clinical and radiographic findings, but it is important to reinforce that the final diagnosis of this condition should be established on microscopic features rather than clinical and radiographic parameters.

This is the second well-documented case report including clinical, radiographic, and microscopic analysis of focal osteoporotic bone marrow defect involving dental implant. Despite the fact that this condition requires no treatment, it could lead to the displacement of the dental implant. In addition, we would like to alert that histopathological analysis is mandatory for precise diagnosis of the radiolucency into posterior mandibular region of the adult woman associated or no with dental implant placement.