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Journal of Oral Science & Rehabilitation No. 3, 2016

What i s the mo st se ve re ea rly c om plic a t i o n co nce rni ng de ntal i mplants? The placement of dental implants, although not without early complications—which are usually self-limited—has become a scheduled,routineandstandardizedsurgicalprocedure.However, it is important that education in oral implantology adequately covertheimmediatebleedingcomplications,especiallyinthefloor ofthe mouth,that mayarise andthat, although infrequent, maybe severe, sometimes even life-threatening, and require hospitaliza- tion foremergencytreatment. The interforaminal area in the mandible is quite often considered as the easiest region in which to insert dental implants, such as placing two implants to support an overdenture. However, the mostseriousbleedingaccidentsoccurinthisregionowingtoinjury of the terminal branches of the sublingual or submental arteries if the lingual cortical plate is perforated during drilling or implant placement.Thisvascularinjurycantriggermassiveinternalbleed- ing in the mouth floor, which expands, causing protrusion and dis- placement of the tongue and sometimes subsequent obstruction ofthe airways, which may necessitate an emergencytracheotomy or even be fatal. Thus, the clinician should not treat placement of anteriormandibularimplantslightlyinthebeliefthatplacementin this region is easy. In orderto minimize the possibilityof perforating the lingual corti- cal plate, some authors recommend placing implants that are not verylong(10–12mm)intheanteriorregionofthemandible.Tilting implants in a buccolingual direction, tipping the implant apex towardthevestibule, is anotheroption. Perhapsthe most important factor concerning minimization of the risk of these complications is that the surgeon carrying out the implant therapy should have extensive anatomical knowledge ofthis area, including the impor- tant anatomical structures located inthe sublingual space. Dr. Miguel Peñarrocha Diago Co-Editor Volume 2 | Issue 3/2016 03 Journal of Oral Science & Rehabilitation Edi to r i al Oral Science Rehabilitation Journal of & Volume 2 | Issue 3/201603

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