Hemorrhage Secondary to Interforaminal Implant Surgery: Anatomical Considerations and Report of a Case
Understanding the anatomy of the floor of mouth is very important as severe submandibular hemorrhages are life threatening. This case report illustrates the potential hemorrhage consequences of implant surgery within the interforaminal region. The highly vascularized interforaminal region is susceptible to hemorrhage, which can be induced simply by instruments causing vascular trauma. The risk of intraoperative bleeding can be minimized by painstaking preoperative clinical and radiological examination but cannot be averted as it is inherent in the underlying anatomy of the region.
Figure 1. Schematic drawing of the collateral blood supply to the floor of the mouth. Figure 2. Schematic of a mandible viewed from posterior. Note the highlighted areas of nutrient foramina that may contain neural structures and note their percentage distribution in a mesiodistal direction. Figure 3. Localization of bleeding from the lingual gingival. Figure 4. (a and b) Control of bleeding using an electrical cauterization. Figure 5. Postoperative panoramic radiograph after placement of 4 interforaminal implants and complete control of lingual bleeding.
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