Detection of Vascular Pathways of Oral Mucosa Influencing Soft- and Hard Tissue Surgeries by Latex Milk Injection

Abstract

In this methodological study, the purpose was to visualize the macroscopic vascular pathway of the oral mucosa. Corpses were injected and fixed with Thiel's solution for embalming to keep the natural color, fresh texture, and elasticity of the tissues. Latex milk injection is a technique used to stain blood vessels. A combination of Thiel's embalming method and latex milk injection allows surgeons to work on a raw specimen and identify the distribution and anastomosis of vessels macroscopically in the oral mucosa for flap/incision design in periodontal and maxillofacial surgeries. The latex milk contains radiopaque material that enables clinicians to visualize the pathway of the blood vessels radiographically. A step-by-step protocol is described for the correct adjustment of Thiel embalming and latex milk injection. The combined application of both methods allows the clinician to understand anatomical structures practically. As a result, proper incisions and flaps can be designed, which prevents neurovascular damage, intraoperative bleeding, and postoperative morbidity during patient surgery.

Latex-injected, non-decapitated, saturated salt method-embalmed cadaver technique development and application as a head and neck surgery training model

“…In previous studies, the specimens were freshly obtained, defrosted, and embalmed before injection or embalmed after injection [ 6 – 8 , 12 ]. In the present study, we used cadavers embalmed with a saturated salt solution.…”

“…However, this approach does not preserve the anatomical relationships of the neck because the suggested cut levels were at the fourth or the fifth cervical vertebra, while the cricoid cartilage’s inferior border is usually at the level of the seventh cervical vertebra [ 7 , 9 ]. Thiel’s method-embalmed cadavers have been used in oral vascular studies [ 10 – 12 ]. Conventional formaldehyde-embalmed cadavers have been the least used in cranial and extracranial vascular studies [ 5 , 13 , 14 ].…”

Periodontal Wound Healing and Tissue Regeneration: A Narrative Review

“…In periodontal surgery, a comprehensive anatomical understanding is significant for flap design with incision. To prevent complications in wound healing and angiogenesis, an accurate cognition on the branching of periosteal vessels is required [ 34 , 35 ]. It is widely accepted that flap elevations without a vertical incision benefit from accelerating blood supply and favorable wound healing, resulting in the improvement of esthetic outcomes, better patient satisfaction, and minimal risk of scarring [ 34 , 36 ].…”

Vascular survey of the maxillary vestibule and gingiva—clinical impact on incision and flap design in periodontal and implant surgeries

“…Before dissection, the latex milk–injected head specimens were analyzed by multislice, spiral CT (Siemens, Somatom Emotion, Munich, Germany). Since the latex milk is radiopaque [ 27 ], vascular surveys of the MA, PSAA, IOA, FA, and SLA were investigated. Their sub-branches in the maxillary vestibule together with their anastomoses and divisions were compared.…”

“…The method of injection was followed according to Shahbazi et al [27]. The common carotid arteries (CCAs) were flushed with Thiel solution [28][29][30][31][32] close to pressure of 0.5 bar.…”