VASCULAR COMPLICATIONS THAT COULD OCCUR IN IMPLANT SURGERY IN THE MANDIBULAR INTERFORAMINAL REGION AND THEIR MANAGEMENT

Yıl 2023, , 175 - 182, 18.01.2023

Bilgesu Kurt , İnci Rana Karaca

https://doi.org/10.54617/adoklinikbilimler.1141080

Öz

The mandibular interforaminal region is a preferred area in many oral, dental and maxillofacial surgery protocols, especially in dental implant applications. Case reports in recent years show that many complications can be encountered in the mandibular interforaminal region. The most dangerous and life-threatening of these are lingual artery injuries that can reach up to upper airway obstruction. Avoiding this complication, which can be encountered regardless of experience, is only necessary to have a good knowledge of the vascular anatomy of the mandibular interforaminal region and to perform the necessary radiographic examinations before the procedure. When such a bleeding complication is encountered in cases such as insufficient radiographic examination of the patient or the presence of anatomical variation, the physician should be equipped with the knowledge and equipment to manage the process and the complication. In this study, the anatomical vascular anatomy of the mandibular interforaminal region, the lingual foramen and their frequency, together with the literature on complication avoidance and coping methods are summarized. Thus, it is aimed to refresh the knowledge of dentists about this serious complication.

Anahtar Kelimeler

LINGUAL ARTERY, LINGUAL FORAMINA, IMPLANT

Mandibular İnterforaminal Bölgede İmplant Cerrahisinde Karşılaşılabilecek Vasküler Komplikasyonlar ve Yönetimi

Öz

Mandibular interforaminal bölge, birçok ağız ,diş ve çene cerrahisi protokolünde özellikle de dental implant uygulamalarında tercih edilen bir alandır. Son yıllardaki vaka raporları, mandibular interforaminal bölgede birçok komplikasyonla karşılaşılabileceğini göstermektedir. Bunlardan en tehlikeli ve yaşamı tehdit edeni de üst solunum yolu obstrüksüyonuna kadar varabilen lingual arter yaralanmalarıdır. Tecrübeye bağlı olmaksızın karşılaşılabilecek bu komplikasyondan kaçınmak ancak mandibular interforaminal bölgenin vasküler anatomisine hakim olmak, işlem öncesi gerekli radyografik tetkik ve incelemeleri yapmış olmaktan geçmektedir. Hastayla ilgili yetersiz radyografik tetkik bulunması ya da anatomik varyasyon varlığı gibi durumlarda bu şekilde bir kanama komplikasyonuyla karşı karşıya kalındığındaysa, hekimin süreci ve komplikasyonu yönetebilecek bilgi ve donanımda olması gereklidir. Bu çalışmada mandibular interforaminal bölgesinin anatomik vasküler anatomisi, lingual foramenler ve bulunma sıklıklarıyla birlikte komplikasyondan kaçınma ve başa çıkma yöntemleriyle ilgili literatür özetlenmiştir. Böylece diş hekimlerinin bu ciddi komplikasyonla ilgili bilgilerini tazelemek amaçlanmaktadır.

Anahtar Kelimeler

LİNGUAL ARTER, LİNGUAL FORAMİNA, İMPLANT

Kaynakça

• 1. Williams P, Warwick R, Dyson M, Bannister L. Gray’s Anatomy. 37th edn, Churchill Livingstone. Edinburgh pp748. 1989;406.
• 2. Dubrul EL. Sicher's oral anatomy. 1980.
• 3. Katsumi Y, Tanaka R, Hayashi T, Koga T, Takagi R, Ohshima H. Variation in arterial supply to the floor of the mouth and assessment of relative hemorrhage risk in implant surgery. Clinical Oral Implants Research. 2013;24(4):434-40.
• 4. Seki S, Sumida K, Yamashita K, Baba O, Kitamura S. Gross anatomical classification of the courses of the human lingual artery. Surgical and Radiologic Anatomy. 2017;39(2):195-203.
• 5. Lemaire V, Jacquemin G, Medot M, Fissette J. Thyrolingual trunk arising from the common carotid artery a case report. Surgical and Radiologic Anatomy. 2001;23(2):135-7.
• 6. Buffoli B, Verzeletti V, Rezzani R, Rodella LF. Unusual branch of the lingual artery supplies the infrahyoid muscles. Anatomical Science International. 2020;95(1):153-5.
• 7. McDonnell D, Nouri MR, Todd M. The mandibular lingual foramen: a consistent arterial foramen in the middle of the mandible. Journal of anatomy. 1994;184(Pt 2):363.
• 8. Kikuta S, Iwanaga J, Kusukawa J, Tubbs RS. Triangles of the neck: a review with clinical/surgical applications. Anatomy & Cell Biology. 2019;52(2):120-7.
• 9. Tagaya A, Matsuda Y, Nakajima K, Seki K, Okano T. Assessment of the blood supply to the lingual surface of the mandible for reduction of bleeding during implant surgery. Clinical oral implants research. 2009;20(4):351-5.
• 10. Sutton R. The practical significance of mandibular accessory foramina. Australian dental journal. 1974;19(3):167-73.
• 11. Nakajima K, Tagaya A, Otonari-Yamamoto M, Seki K, Araki K, Sano T, et al. Composition of the blood supply in the sublingual and submandibular spaces and its relationship to the lateral lingual foramen of the mandible. Oral surgery, oral medicine, oral pathology and oral radiology. 2014;117(1):e32-e8.
• 12. Kalpidis CD, Setayesh RM. Hemorrhaging associated with endosseous implant placement in the anterior mandible: a review of the literature. Journal of periodontology. 2004;75(5):631-45.
• 13. Bavitz JB, Harn SD, Homze EJ. Arterial supply to the floor of the mouth and lingual gingiva. Oral surgery, oral medicine, oral pathology. 1994;77(3):232-5.
• 14. Yildirim YD, Güncü GN, Galindo-Moreno P, Velasco-Torres M, Juodzbalys G, Kubilius M, et al. Evaluation of mandibular lingual foramina related to dental implant treatment with computerized tomography: a multicenter clinical study. Implant Dentistry. 2014;23(1):57-63.
• 15. Kawai T, Asaumi R, Sato I, Yoshida S, Yosue T. Classification of the lingual foramina and their bony canals in the median region of the mandible: cone beam computed tomography observations of dry Japanese mandibles. Oral radiology. 2007;23(2):42-8.
• 16. Von Arx T, Matter D, Buser D, Bornstein MM. Evaluation of location and dimensions of lingual foramina using limited cone-beam computed tomography. Journal of oral and maxillofacial surgery. 2011;69(11):2777-85.
• 17. Katakami K, Mishima A, Kuribayashi A, Shimoda S, Hamada Y, Kobayashi K. Anatomical characteristics of the mandibular lingual foramina observed on limited cone‐beam CT images. Clinical oral implants research. 2009;20(4):386-90.
• 18. Trikeriotis D, Paravalou E, Diamantopoulos P, Nikolaou D. Anterior mandible canal communications: a potential portal of entry for tumour spread. Dentomaxillofacial radiology. 2008;37(3):125-9.
• 19. Liang X, Jacobs R, Lambrichts I, Vandewalle G. Lingual foramina on the mandibular midline revisited: a macroanatomical study. Clinical Anatomy: The Official Journal of the American Association of Clinical Anatomists and the British Association of Clinical Anatomists. 2007;20(3):246-51.
• 20. Oettlé AC, Fourie J, Human‐Baron R, van Zyl AW. The midline mandibular lingual canal: importance in implant surgery. Clinical implant dentistry and related research. 2015;17(1):93-101.
• 21. Babiuc I, Tarlungeanu I, Pauna M. Cone beam computed tomography observations of the lingual foramina and their bony canals in the median region of the mandible. Rom J Morphol Embryol. 2011;52(3):827-9.
• 22. Wang Y-M, Ju Y-R, Pan W-L, Chan C-P. Evaluation of location and dimensions of mandibular lingual canals: a cone beam computed tomography study. International Journal of Oral and Maxillofacial Surgery. 2015;44(9):1197-203.
• 23. Zhang C, Zhuang L, Fan L, Mo J, Huang Z, Gu Y. Evaluation of mandibular lingual foramina with cone-beam computed tomography. Journal of Craniofacial Surgery. 2018;29(4):e389-e94.
• 24. Xie L, Li T, Chen J, Yin D, Wang W, Xie Z. Cone-beam CT assessment of implant-related anatomy landmarks of the anterior mandible in a Chinese population. Surgical and Radiologic Anatomy. 2019;41(8):927-34.
• 25. Trost M, Mundt T, Biffar R, Heinemann F. The lingual foramina, a potential risk in oral surgery. A retrospective analysis of location and anatomic variability. Annals of Anatomy-Anatomischer Anzeiger. 2020;231:151515.
• 26. Gültekin S, Araç M, Çelik H, Karaosmaoğlu AD, IŞIK S. Mandibulanın lingual vasküler kanallarının dental BT ile değerlendirilmesi. Tanısal ve Girişimsel Radyoloji (Yeni Adı: Dİagnostic & Intervent Radiol). 2003;9(2):188-91.
• 27. Rosano G, Taschieri S, Gaudy JF, Testori T, Del Fabbro M. Anatomic assessment of the anterior mandible and relative hemorrhage risk in implant dentistry: a cadaveric study. Clinical oral implants research. 2009;20(8):791-5.
• 28. Murlimanju B, Prakash K, Samiullah D, Prabhu LV, Pai MM, Vadgaonkar R, et al. Accessory neurovascular foramina on the lingual surface of mandible: incidence, topography, and clinical implications. Indian Journal of Dental Research. 2012;23(3):433.
• 29. Mraiwa N, Jacobs R, Moerman P, Lambrichts I, van Steenberghe D, Quirynen M. Presence and course of the incisive canal in the human mandibular interforaminal region: two-dimensional imaging versus anatomical observations. Surgical and radiologic anatomy. 2003;25(5):416-23.
• 30. Scaravilli MS, Mariniello M, Sammartino G. Mandibular lingual vascular canals (MLVC): evaluation on dental CTs of a case series. European journal of radiology. 2010;76(2):173-6.
• 31. Pigadas N, Simoes P, Tuffin J. Massive sublingual haematoma following osseo-integrated implant placement in the anterior mandible. British Dental Journal. 2009;206(2):67-8.
• 32. Krenkel C, Holzner K. Lingual bone perforation as causal factor in a threatening hemorrhage of the mouth floor due to a single tooth implant in the canine region. Die Quintessenz. 1986;37(6):1003-8.
• 33. Mason ME, Triplett RG, Alfonso WF. Life-threatening hemorrhage from placement of a dental implant. Journal of oral and maxillofacial surgery. 1990;48(2):201-4.
• 34. ten Bruggenkate CM, Krekeler G, Kraaijenhagen HA, Foitzik C, Oosterbeek HS. Hemorrhage of the floor of the mouth resulting from lingual perforation during implant placement: a clinical report. International Journal of Oral & Maxillofacial Implants. 1993;8(3).
• 35. Ratschew C. Life-threatening hemorrhage during placement of dental implants in the mandible. A case report. Disch Zahnaeztl Z. 1994;49:65-7.
• 36. Darriba MA, Mendonça-Caridad JJ. Profuse bleeding and life-threatening airway obstruction after placement of mandibular dental implants. Journal of oral and maxillofacial surgery. 1997;55(11):1328-30.
• 37. Worthington P. Severe hemorrhage after implant surgery. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology and Endodontology. 1999;1(88):1.
• 38. Mordenfeld A, Andersson L, Bergström B. Hemorrhage in the floor of the mouth during implant placement in the edentulous mandible: a case report. International Journal of Oral & Maxillofacial Implants. 1997;12(4).
• 39. Givol N, Chaushu G, Halamish‐Shani T, Taicher S. Emergency tracheostomy following life‐threatening hemorrhage in the floor of the mouth during immediate implant placement in the mandibular canine region. Journal of periodontology. 2000;71(12):1893-5.
• 40. Niamtu III J. Near-fatal airway obstruction after routine implant placement. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology. 2001;92(6):597-600.
• 41. Boyes-Varley J, Lownie J. Haematoma of the floor of the mouth following implant placement. SADJ: journal of the South African Dental Association= tydskrif van die Suid-Afrikaanse Tandheelkundige Vereniging. 2002;57(2):64-5.
• 42. Laboda G. Life-threatening hemorrhage after placement of an endosseous implant: report of case. Journal of the American Dental Association (1939). 1990;121(5):599-600.
• 43. Krenkel C, Holzner K, Poisel S. Hematoma of the mouth floor following oral surgery and its anatomical characteristics. Deutsche Zeitschrift fur Mund-, Kiefer-und Gesichts-Chirurgie. 1985;9(6):448-51.
• 44. Goldstein B. Acute dissecting hematoma: a complication of oral and maxillofacial surgery. Journal of Oral Surgery (American Dental Association: 1965). 1981;39(1):40-3.
• 45. Hull M. Life-threatening swelling after mandibular vestibuloplasty. Journal of Oral Surgery (American Dental Association: 1965). 1977;35(6):511-4.
• 46. Burke RH, Masch GL. Lingual artery hemorrhage. Oral surgery, oral medicine, oral pathology. 1986;62(3):258-61.
• 47. Tepper G, Hofschneider UB, Gahleitner A, Ulm C. Computed tomographic diagnosis and localization of bone canals in the mandibular interforaminal region for prevention of bleeding complications during implant surgery. International Journal of Oral & Maxillofacial Implants. 2001;16(1).
• 48. YILDIZ FN, AKARSLAN ZZ. Multiple Lingual Foramen ve Kanallarının Radyografik Olarak Değerlendirilmesi. ADO Klinik Bilimler Dergisi.7(2):1479-84.
• 49. Woo B, Al-Bustani S, Ueeck B. Floor of mouth haemorrhage and life-threatening airway obstruction during immediate implant placement in the anterior mandible. International journal of oral and maxillofacial surgery. 2006;35(10):961-4.