2012 Volume 25 Issue 3 Pages 468-475
Although dental implant placement is considered to be a safe surgical procedure, this report focuses on two cases with severe hemorrhage during implant placement in the mandible. Excessive hematoma formation in the mouth floor resulted from arterial or venous trauma that occurred during implant socket preparation. The first case was a 60-year-old man who suffered hemorrhage and the formation of a large hematoma in the mouth floor that occurred during insertion socket preparation in the lateral incisor position on the right side of the mandible. The second case was a 57-year-old woman in whom a large hematoma formed in the mouth floor 4 hours after implant placement in the first molar site on the right side of the mandible.
In the first case, the dentist did not consider that the lingual cortex had been perforated. Therefore, we suspected that a small branch of the sublingual artery had been injured in the mandible with a twist drill, and that the vessel had withdrawn into the mouth floor. In the second case, the dentist involved identified a perforation of the lingual cortex, although bleeding had been noticed during the surgery and hemostasis had been achieved at that time. Swelling occurred 4 hours after surgery, although it progressed relatively slowly. Therefore, we suspected that a small vein in the mouth floor had been injured. Severe airway obstruction did not occur in either case.
