The potential for facial artery injury during mandibular third molar extraction. An anatomical study using contrast‐enhanced computed tomography

Abstract

The purpose of this study was to evaluate the risk of injury to the facial (FA) and related arteries during mandibular third molar (MTM) extraction using contrastenhanced computed tomography (CE-CT). CE-CT images of the MTM region were retrospectively reviewed. The area of the MTM was equally divided into three zones in the coronal images from mesial to distal, that is, zone 1, zone 2, and zone 3. The FA, submental artery (SMA), and sublingual artery (SLA) were identified. The distance from the mandible to FA, SMA, and SLA and the diameter of the FA, SMA, and SLA was measured in three zones, respectively. The thickness of the facial soft tissues and width of the mandible were measured at their maximum. The mean distance from the FA to the buccal cortical bone in zone 1, zone 2 and zone 3 was 2.24 mm, 2.39 mm and 1.67 mm, respectively. The SMA and SLA were found to be distal to the mandible. The mean diameter of the FA was 1.26 mm in males and 1.04 mm in females, respectively (p < 0.0001). The distance between the FA and buccal cortical bone of the mandible, and the patients' weight showed moderate correlation in zones 1 and 2. Based on our findings, the FA can be damaged if the surgical invasion reaches the facial soft tissues during MTM surgery. The patients' weight might be a good predictor for FA injury when CE-CT is not available.

The complete anatomy of the lingual nerve: A meta‐analysis with implications for oral and maxillofacial surgery

“…This excision puts the LN at risk of injury caused by severe inflammatory reactions or massive bleeding (Günenç Bes ¸er et al, 2018). Massive hemorrhage may occur due to potential damage to the facial artery, especially during third molar extractions (Takeshita et al, 2021).…”

The notch of the mandible: what do different fields call it?

“…In oral surgery, the facial artery can be at risk for injury during various surgical procedures of the posterior mandible such as during releasing incisions or mandibular third molar extraction [ 1 , 2 ]. One anatomical landmark used to identify this vessel is a variant bony notch located on the inferior border of the mandible which is also anterior to the attachment of the masseter muscle ( Figs.…”