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ePaper created 2016-03-07, 22:38:59 | version 1.38.0
38 Volume 2 | Issue 1/2016 Journal of Oral Science & Rehabilitation Rev iew of th e a rteria l anato my i n the ante r i o r mandi ble found that narrower and shorter implants tended to be selected when the available bone was studied using CBCT cross-sectional im- ages, compared with both digital panoramic radiographs and CBCT-generated panoramic views.29 Moreover, guided implant surgery maypotentiallyenhance safetyevenfurtherby avoiding vessels, nerves and other anatomical structuresifthecaseisplannedproperly.How- ever, at present, this cannot be definitively stated yet. In a recent review on guided sur- gery,Tahmaseb et al.found a mean deviation of upto7.1 mm.30 Itisnecessarytocontrolthefac- tors that significantly affect the accuracy of guided surgery, such as the experience of the operator,31 the software used,32, 33 the type of support for the guided template (soft tissue, bone or dental support), the type of surgery (flap vs. flapless) and the guided surgery sys- tem used.30 The anterior region of the mandible has a high bone density, Type I according to the Lekholm and Zarb classification.34 This prop- erty helps to achieve adequate primary stabil- ity, which, together with the absence of anatomical limitations, such as the inferior alveolar nerve and reduced atrophy, has con- ventionally led students to place their first im- plants in this area. The risks of placement of dental implants in the anterior region of the mandible highlight that the conventional rec- ommendation to students to place their first implants in the anterior region ofthe mandible, owing to the absence of important anatomical structures, should be reviewed. Conclusion The sublingual region is densely supplied by several arteries that often anastomose. Injur- ing these vessels can cause serious bleeding and even threaten the patient’s life through the blocking of the upper airway. In order to avoid these complications, the operator should have an extensive anatomical knowledge of this area. Moreover, tilting of implants, the avoid- ance of long dental implants, and careful surgi- cal planning with the aid of 3-D imaging and planning software may also help to reduce the risks when placing implants in the anterior mandible. Competinginterests The authors declare that they have no competing interestsrelatedtothisstudy.