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Variations of Vascular Distribution in the Mandibular Anterior Lingual Region: A High Risk of Vascular Injury During Implant Surgery

Fujita, Shuhei DDS*; Ide, Yoshinobu PhD, DDS; Abe, Sinichi PhD, DDS

doi: 10.1097/ID.0b013e31825cbb7d
Clinical Science and Techniques
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Purpose: To clarify variations of vascular distribution around the mandibular anterior tooth lingual region, an area in which vascular injuries have often been reported during dental implant surgery. The reasons for such injuries in this region are discussed from an anatomical perspective.

Materials and Methods: Anatomical dissections were performed on 100 sides of 50 cadavers used for anatomy education. Ten sides of 5 cadavers were injected intravascularly with methyl methacrylate, and penetration of the mandible was closely evaluated.

Results: In the mandibular anterior tooth lingual region, both the sublingual and submental arteries showed various distribution patterns. Distal branches basically penetrated the bone.

Conclusions: In the mandibular anterior tooth lingual region, the sublingual and submental arteries traveled from the vicinity of the mylohyoid muscle attachment along the bone surface in an anterosuperior direction. Many of these blood vessels penetrated the alveolar mucosa in the anterior tooth region, and many distal branches of the vessels also finally penetrated the bone. This seems to explain why many vascular injuries are encountered around the mandibular anterior tooth lingual region during implant surgery.

*Doctorial Student, Department of Anatomy, Tokyo Dental College, Mihama-ku, Chiba-City, Chiba, Japan.

Professor, Department of Anatomy, Tokyo Dental College, Mihama-ku, Chiba-City, Chiba, Japan.

Professor and Chairman, Department of Anatomy, Tokyo Dental College, Mihama-ku, Chiba-City, Chiba, Japan.

Repeat requests and correspondence to: Shinichi Abe, PhD, DDS, Department of Anatomy, Tokyo Dental College 1-2-2 Masago, Mihama-ku, Chiba-City, Chiba 261-8502, Japan, Phone: 00-81-43-270-3757, Fax: 00-81-43-277-4010, E-mail: abesh@tdc.ac.jp

© 2012 Lippincott Williams & Wilkins, Inc.