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Implant Tribune Italian Edition - Settembre 2016 9 Ricerca & Clinica Review of the arterial vascular anatomy for implant placement in the anterior mandible José Carlos Balaguer Marti*, Juan Guarinos**, Pedro Serrano Sánchez**, Amparo Ruiz Torner*, David Peñarrocha Oltra*, Miguel Peñarrocha Diago* Richiedilatuacopiagratuita scrivi a segreteria@tueorservizi.it o sfoglia il PDF in versione E-Paper sul sito www.dtscience.com * Department of Stomatology, Faculty of Medicine and Odontology, University of Valencia, Valencia, Spain. ** Department of Anatomy, Faculty of Medicine and Odontology, University of Valencia, Valencia, Spain. < pagina 1 Serious problems and complica- tions may result from inadequate treatment planning, some from careless instrumentation, and some from lack of appropriate precau- tions»2 . Some important early com- plications after dental implantation may be neurological3,4 , infections5 and hemorrhages6,1,7 . Neurological complications are the most fre- quent (8.5%)4 , followed by infections (1.8%)8 , and severe, life-threatening hemorrhagic complications are the most rare, with only 15 cases re- ported in the literature6 . Although severe immediate hemorrhagic complications are infrequent, the mechanical pressure from sealed bleeding spaces adjacent to the up- per airway may become life-threat- eningextremelyquickly1 .Therefore, these are the most serious complica- tions, especially when they occur in the anterior region of the mandible. Laceration of the inferior alveolar artery can lead to severe bleeding, but the compression by the implant itself can stop the hemorrhage. The floor of the mouth is not a closed cavity like the canal of the inferior alveolar nerve; therefore, if bleed- ing occurs, the blood collects in the supramylohyoid space, pressing the tongue to the palate. Thus, perfora- tion of the lingual cortical plate in the anterior region of the mandible can cause uncontrollable bleeding of the sublingual artery, which re- quires in-hospital treatment6 . The practitioner must have an extensive knowledge of the anatomy of the surgical field to avoid this compli- cation. This paper highlights the essential anatomical details that must form part of the practitioner’s knowledge in order to perform den- tal implant surgery in the anterior mandible with maximum safety and minimal risk. Materials & methods A study of the anatomical body structures located in the anteri- or mandible and floor of mouth was performed. The cadavers used were donated by the Univer- sity of Valencia (Valencia, Spain). An intravascular perfusion with colored latex was performed for better discrimination of the ves- sels. The tissue was dissected with the blunt technique principally— closed scissors were inserted into the connective tissue and then opened. The structures were re- corded photographically. > pagina 10 Implant Tribune Italian Edition - Settembre 20169