Variations of vascular distribution in the mandibular anterior lingual region:  a high risk of vascular injury during implant surgery.
OBJECTIVE
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.


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.
Department of Anatomy, Tokyo Dental College, Mihama-ku, Chiba-City, Chiba, Japan.
Shuhei
S
Fujita
Yoshinobu
Y
Ide
Sinichi
S
Abe
D000368:Aged; D063405:Anatomic Variation; D001158:Arteries / Q000033:anatomy & histology / Q000293:injuries; D002102:Cadaver; D003481:Cuspid / Q000098:blood supply; D003724:Dental Arch / Q000098:blood supply; D003758:Dental Implantation, Endosseous / Q000009:adverse effects; D004210:Dissection / Q000379:methods; D005260:Female; D006801:Humans; D007180:Incisor / Q000098:blood supply; D007431:Intraoperative Complications; D008297:Male; D008334:Mandible / Q000098:blood supply*; D020366:Methylmethacrylate; D008875:Middle Aged; D009061:Mouth Mucosa / Q000098:blood supply; D009334:Neck Muscles / Q000098:blood supply; D012307:Risk Factors; D014059:Tongue / Q000098:blood supply
D020366:Methylmethacrylate