Hemorrhage Related to Implant Placement in the Anterior Mandible

Jo, Ji-Ho; Kim, Su-Gwan; Oh, Jaewon

doi:10.1097/id.0b013e3182181c6b

Cited by 26 publications

(17 citation statements)

References 18 publications

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“…This occurs, in particular, in the case of severe mandibular atrophy, if the patient takes anticoagulants for a prolonged period of time, or if he has coagulopathy or hypertension. 2,4,18 According to Vandewalle et al, 3 the artery present in the perforated canal is of sufficient size to cause severe bleeding, when damaged during oral surgery. According to Gahleitner et al, 6 the vessel present in the bone canal is proportional to the original sublingual artery and is therefore able to determine significant intraoperative bleeding.…”

Section: Discussionmentioning

confidence: 99%

“…However, in the literature, serious complications resulting from dental implantology procedures have been reported. 2 This may occur during implant's placement, when the accidental perforation of the lingual cortical plate is caused, with injury to adjacent vascular structures. 16 The bleeding causes infarction of the connective tissues of the floor of the mouth.…”

Section: Discussionmentioning

confidence: 99%

“…1 Previous studies have analyzed the vascularization of the anterior region of the mandible in relation to the hemorrhagic risk during oral surgery. 2 The purpose of this article was to evaluate this site in relation to the presence of perforating canals. Differently from the available literature, this study was performed using high-resolution cone beam computed tomography (CBCT) images and three-dimensional reconstructions.…”

mentioning

confidence: 99%

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Intraosseous Vascularization of Anterior Mandible

Bari

Coronelli²,

Cicconetti³

2014

Journal of Craniofacial Surgery

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The anterior mandible was initially considered a safe zone from a surgical point of view. Over time, serious complications resulting from dental implantology procedures have been reported. This has led to a greater focus on vascularization of the interforaminal region. The purpose of this article was to evaluate the anterior mandibular region in relation to the presence of canals perforating the buccal and lingual cortical plates. DICOM (Digital Imaging and Communications in Medicine) files of 100 cone beam computed tomography scans were analyzed by imaging software. All radiographic cross-sections between the mental foramina were examined to detect the presence and location of perforating buccal or lingual canals. Lingual perforating canals are present in 98% of the cohort. The most common site is the symphysis region. The presence of 2 lingual canals cranially and caudally to the genial apophysis has been found in 39%. Vestibular perforating canals are absent in 61%. The anterior mandible has several lingual perforating canals, which are variable in number and location. Imaging software is a valuable aid in presurgical planning. Because of the higher prevalence of perforating canals in the symphysis region, this site should be preserved.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Intraosseous Vascularization of Anterior Mandible

Bari

Coronelli²,

Cicconetti³

2014

Journal of Craniofacial Surgery

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“…Extensive hemorrhage in the floor of the mouth may occur during or after implant placement in the mental interforaminal region . This may even result in a life‐threatening acute airway obstruction .…”

Section: Reducing Risks For Neurovascular Trauma By Preoperative Diagmentioning

confidence: 99%

“…Significant hemorrhages are mostly described after anterior mandibular implant placement or in sinus augmentation before or during implant placement. For mandibular implant placement, a review of the literature shows at least 19 case reports related to hemorrhage in the floor of the mouth (10,14,18,19,23,29,38,39,42,48,49,67,69,74,79,81,83,102,116) and potentially life-threatening upper airway obstruction (14,23,48,49,67,69,79). Those hemorrhages were mostly related to lingual perforations, long implants (≥15 mm) or deep osteotomy preparations.…”

Section: Intra-oral Hemorrhagementioning

confidence: 99%

Neurovascular disturbances after implant surgery

Jacobs¹,

Quirynen²,

Bornstein³

2014

Periodontology 2000

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With a steadily increasing impact of oral implant placement in daily practice, the number of reported surgical complications has also been growing. Recent studies reveal significant variation in the occurrence and morphology of neurovascular canal structures in the jaw bone. All those structures contain a neurovascular bundle, the diameter of which may be large enough to cause clinically significant damage. Therefore, it has become obvious that presurgical radiographic planning of jaw-bone surgery should pay attention to the neurovascular structures and their likely variations, in addition to examining many other factors, such as jaw-bone morphology and volume, bone trabecular structure and the absence of bone or tooth pathology. A critical review is accomplished to explore the potential risks for neurovascular complications after implant placement, with evidence derived from histologic, anatomic, clinical and radiologic studies. In this respect, cross-sectional imaging can often be advocated, as it is obvious that the inherent three-dimensional nature of jaw-bone anatomy may clearly benefit from a detailed spatial image analysis. Although this could initially be realized by conventional computed tomography, in current practice, dentomaxillofacial cone beam computed tomography might be used, as it offers high-quality images at low radiation dose levels and costs.

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Analysis of the mylohyoid nerve in elderly Japanese cadavers for dental implant surgery

Koga

Sato

et al. 2020

Clinical & Exp Dental Res

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Objectives Injury to the mandibular nerve (MN) branches may cause pain and irregular occlusal movement during mastication after mandibular dental treatments. Growing evidence indicates that the calcitonin gene‐related peptide (CGRP) plays a key role in the development of peripheral sensitization and the associated enhanced pain, suggesting it may be a sign to ensure a safe and reliable dental implant treatment. Our focus was on the distribution of the MN branches and their communication with the lingual nerve (LN), the localized expression of CGRP, and the identification of a pain area related to the mylohyoid muscle (MM) fascia in the mandibular floor. Material and Methods In this study, MM samples from 440 sides of 303 human cadavers aged 61–103 years were examined microscopically and immunohistochemically. These data were further evaluated by the use of principal component analysis. Results A complex but weak attachment site was identified for the fascia of the MM. CGRP expression was mainly located in small vessels and was scattered throughout the whole fascia of the MM. Communication between the MN and LN was found in 62.5% (275/440) of the samples. The results from the principal component analysis showed that the positive contributions were from the descending branch in the premolar region (correlation coefficient value R = 0.665), the ascending branch in the molar region (R = 0.709) and the intermediate branch of the digastric branch (R = 0.720) in component 1. In the fascia off the MM, strongly labeled CGRP‐positive cells were also found around the blood vessels and the nerve. Conclusions The findings reported in this study indicate that there is a risk of damage when pulling the fascia off the MM at the border of the molar and premolar regions during dental implant surgery.

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Hemorrhage Related to Implant Placement in the Anterior Mandible

Cited by 26 publications

References 18 publications

Intraosseous Vascularization of Anterior Mandible

Intraosseous Vascularization of Anterior Mandible

Neurovascular disturbances after implant surgery

Analysis of the mylohyoid nerve in elderly Japanese cadavers for dental implant surgery

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