Critical Hemorrhage in the Floor of the Mouth During Implant Placement in the First Mandibular Premolar Position: A Case Report

Floor of mouth haemorrhage and life-threatening airway obstruction during immediate implant placement in the anterior mandible

“…In addition to bimanual pressure/compression, haemostatic packing agents may also be used. In some case reports the bleeding was self-limiting and tamponaded as a result of compression from the pooling blood and pressure from the adjacent muscles and soft tissue 6,8,9,13 . If the bleeding fails to tamponade and becomes a dissecting haematoma then the source of bleeding must be identified surgically and definitively controlled by tying or clipping the vessels responsible.…”

“…The population at increased risk for this include: patients with hypertension, coagulopathies, on anticoagulants, vascular malformations and malignant invasion 9 . Our patient's past medical history was not significant for any of these risk factors.…”

“…Majority of the cases involved the placement of an implant into the mandibular canine region and were the result of perforation of the mandibular lingual cortex 9 . There was one case report of the haemorrhage resulting from an incision that was made too lingual to the alveolar crest and the dissection being carried out supraperiosteally resulting in laceration of the sublingual artery and hypoglossal nerve 4 .…”

Gestion péri-opératoire des patients traités par antithrombotiques en chirurgie orale. Argumentaire

“…Ainsi ont été rapportés : -le sinus maxillaire avec le risque d'hémosinus suite à la lésion de l'artères alvéolaire postéro-supérieure ou antrale [169,175] ; -le plancher buccal avec le risque d'hématome compressif et/ou d'hémorragie grave suite à la lésion de l'artère linguale ou de l'une de ses branches (artère submentale ou submentonnière) [53,75,117,179,186,220,235]. Même si ces événements demeurent exceptionnels, la littérature rapporte régulièrement des cas d'hémorragies graves avec engagement du pronostic vital [75,211,218] dont certaines fatales [107,230].…”

Cone-Beam Computed Tomography Analysis of Mental and Genial Spinal Foramina in a Thai Population

“…As several authors reported on life-threatening hemorrhage in the floor of the mouth subsequent to implant placement in the mental interforaminal region [13][14][15][16]. Therefore, some reports have suggested a relationship between such a surgical incident and the presence of genial spinal (lingual) foramina [4,15,17,18].…”