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Journal of Oral Science & Rehabilitation Issue 01/2016

Volume 2 | Issue 1/2016 35 Journal of Oral Science & Rehabilitation Rev iew of th e a rte r i al anato my i n the ante r i o r mandi ble teries runs along the bottom flange of the mandibular body and through the mylohyoid muscle (Fig.  6). Anastomoses between both sublingual contralateral arteries in the symph- ysisarefrequenttoo(Fig. 7). In summary, the mandibular symphyseal area is supplied by multiple vascular structures from differentoriginsandpresentsavariabilitydepend- entontheanastomosingrelationshipsestablished bytheterminalbranchesofthesestructures.13–15 Discussion The sublingual region is well vascularized, with severalanastomosesthatcanimpairhemostasis if bleeding occurs.7 Treatment can be uncom- fortable for the patient, so the priority is to pre- vent trauma occurring through good anatomical knowledgeoftheareaandproperplanningofthe surgery. Regarding the bony anatomy and muscula- ture of the anterior mandible, the mental spines are located in the mandible’s inner side. Some studieshighlightitsmorphologicalvariability,for example the variability in the distance from the mental spine to the inferior border of the mandible or to apices of the mandibular inci- sors.16 The genioglossus and geniohyoid mus- cles originate from the mental spines, so this variability may increase the risk of damage to these structures when dental implants are placedinthisarea. The digastric fossa is located on the mandible’s inner side, near the lower edge in the paramedianlocation.Therefore,aninjurycaused by piercing of the mandibular cortical bone, for example when placing a dental implant, may af- fectdifferentmusclesdependingonwhetherthe implant preparation is in the medial or parame- dian location in relation to the mandibular sym- physis.17 Three arteries supplythis anatomical region: (a) the sublingual artery,which is a branch ofthe lingual artery; (b) the submental artery, which is a branch of the facial artery; and (c) the chin ar- tery, which is the terminal branch of the inferior alveolarartery.The lingualandfacialarteries are Figs. 3 & 4 Fig. 3 Musculature of the mandible and sublingual artery piercing the mandibular lingual plate. Fig. 4 Anatomical photograph of the arterial supply of the floor of the mouth. Fig. 5 Course of the facial and submental arteries. Fig. 6 Location of the sublingual and submental arteries. (Modified from Kalpidis and Setayesh1 with permission from the American Academy of Periodontology.) Figs. 5 & 6 Volume 2 | Issue 1/201635

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