title: Arterial blood supply variation in the anterior midline mandible: Significance to dental implantology.
abstract: BACKGROUND
  Inter-foraminal implant placement poses a risk to the sublingual artery as it enters the mandibular midline lingual foramen. Lack of consensus on the source of this artery poses a dilemma to surgeons during management of haemorrhagic episodes. Determination of the exact source of this artery is therefore pivotal.
  
  
  METHODS
  This was a cross-sectional descriptive study involving 34 adult human cadavers. The facial and lingual arteries were followed from the external carotid artery to determine whether they terminated as the sublingual artery. Statistical significance tests were done using the Mann-Whitney U test and Pearson product-moment correlation.
  
  
  RESULTS
  There were 30 (88.2 %) males and 4 (11.8 %) females (male/female = 15:2) aged between 25 and 40 years. The origin of the sublingual artery was mainly from the lingual artery (73.5 %), the submental artery (17.6 %), or an anastomotic branch from the two arteries (8.9 %). The mean distance between the mandibular midline lingual foramen (MMLF) and the inferior border of the mandible was 15.58 mm (range 11.03-19.62 mm). The mean thickness of the mandible at the level of the MMLF was 10.89 mm (range 8.00-12.91 mm). No statistically significant difference was found between the two genders with regard to the morphometric measurements.
  
  
  CONCLUSIONS
  The sublingual artery that enters the MMLF was found to be the sublingual artery as either a branch of the lingual artery (73.5 %), the submental artery (17.6 %) or an anastomosis of the lingual and submental arteries (8.9 %).
authors.affiliation: Department of Conservative and Prosthetic Dentistry, University of Nairobi, P.O. Box 54954-00200, Nairobi, Kenya. josegaks@gmail.com.
authors.forename: Joseph
authors.initials: J
authors.lastname: Gakonyo
authors.affiliation: Department of Human Anatomy, University of Nairobi, P.O. Box 25361-00603, Nairobi, Kenya.
authors.forename: Fawzia
authors.initials: F
authors.lastname: Butt
authors.affiliation: Department of Human Anatomy, University of Nairobi, P.O. Box 25361-00603, Nairobi, Kenya.
authors.forename: Philip
authors.initials: P
authors.lastname: Mwachaka
authors.affiliation: Department of Periodontology/Community and Preventive Dentistry, University of Nairobi, P.O. Box 30197, Nairobi, Kenya.
authors.forename: Evelyn
authors.initials: E
authors.lastname: Wagaiyu
keywords: Dental implant; Haemorrhage; Mandibular midline foramen; Sublingual artery