title: Critical hemorrhage in the floor of the mouth during implant placement in the first mandibular premolar position: a case report.
abstract: Although dental implantation is considered to be a safe surgical procedure, this report focuses on a critical hemorrhaging episode associated with implant placement in the first mandibular premolar position. Excessive bleeding and formation of massive lingual, sublingual, and submandibular hematomas were the result of arterial trauma that occurred during the osteotomy preparation. The vascular injury was induced through a perforation of the lingual mandibular cortex. Critical bleeding was conservatively controlled and the case was further handled efficiently with an expectant airway management in a hospital environment. Similar case reports are reviewed in an attempt to draw attention to this rare but potentially life-endangering risk of implant dentistry. Common causes of severe hemorrhage in the floor of the mouth, anatomical considerations, bleeding control measures, and related airway issues are also discussed.
authors.affiliation: Department of Periodontology, Preventive Dentistry and Implant Biology, Aristotle University School of Dentistry, Thessaloniki, Greece.
authors.forename: Christos D
authors.initials: CD
authors.lastname: Kalpidis
authors.forename: Anthony B
authors.initials: AB
authors.lastname: Konstantinidis
mesh_terms: D000328:Adult; D001158:Arteries / Q000293:injuries; D001641:Bicuspid; D015921:Dental Implants / Q000009:adverse effects*; D006406:Hematoma / Q000209:etiology; D006488:Hemostasis, Surgical; D006801:Humans; D007431:Intraoperative Complications; D008297:Male; D008334:Mandible / Q000098:blood supply / Q000601:surgery; D008338:Mandibular Injuries / Q000209:etiology*; D009060:Mouth Floor / Q000473:pathology*; D006472:Oral Hemorrhage / Q000209:etiology*; D010027:Osteotomy / Q000009:adverse effects
chemical_list: D015921:Dental Implants