Massive Lingual and Sublingual Haematoma following Postextractive Flapless Implant Placement in the Anterior Mandible

Dental implants placement in the anterior mandible with flap or flapless technique is a routine procedure and is considered to be safe. However, serious life-threatening complications may occur. We report the first case of massive lingual and sublingual haematoma following postextractive implant pla...

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Main Authors: Luisa Limongelli, Angela Tempesta, Vito Crincoli, Gianfranco Favia
Format: Article
Language:English
Published: Wiley 2015-01-01
Series:Case Reports in Dentistry
Online Access:http://dx.doi.org/10.1155/2015/839098
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author Luisa Limongelli
Angela Tempesta
Vito Crincoli
Gianfranco Favia
author_facet Luisa Limongelli
Angela Tempesta
Vito Crincoli
Gianfranco Favia
author_sort Luisa Limongelli
collection DOAJ
description Dental implants placement in the anterior mandible with flap or flapless technique is a routine procedure and is considered to be safe. However, serious life-threatening complications may occur. We report the first case of massive lingual and sublingual haematoma following postextractive implant placement in the anterior mandible with flapless technique. A 45-year-old female patient underwent placement of four immediately postextractive implants in the anterior mandible using flapless technique. During the procedure, the patient referred intense acute pain and worsening sign of airway obstruction, dysphagia, dyspnea, and speech difficulties. Bimanual compression of the mouth floor, lingual surface of the mandible, and submental skin was maintained for approximately 25 minutes in order to stop the bleeding. Computerized tomography highlighted the massive lingual and sublingual haematoma. The symptoms and signs had almost completely resolved in the next 48 hours. The prevention of these complications is mandatory with clinical and CT analyses, in order to highlight mandibular atrophy and to select carefully the correct length and angulation of bone drilling and to keep more attention to the flapless technique considering the elevation of a lingual mucoperiosteal flap to access the mandibular contour intraoperatively and to protect the sublingual soft tissues and vasculature in high risk cases.
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spelling doaj-art-c9c16a73caad47e1a1a40de74fcf49312025-08-20T02:19:36ZengWileyCase Reports in Dentistry2090-64472090-64552015-01-01201510.1155/2015/839098839098Massive Lingual and Sublingual Haematoma following Postextractive Flapless Implant Placement in the Anterior MandibleLuisa Limongelli0Angela Tempesta1Vito Crincoli2Gianfranco Favia3Department of Interdisciplinary Medicine, Complex Operating Unit of Odontostomatology, Aldo Moro University, Piazza Giulio Cesare 11, 70124 Bari, ItalyDepartment of Interdisciplinary Medicine, Complex Operating Unit of Odontostomatology, Aldo Moro University, Piazza Giulio Cesare 11, 70124 Bari, ItalyDepartment of Interdisciplinary Medicine, Complex Operating Unit of Odontostomatology, Aldo Moro University, Piazza Giulio Cesare 11, 70124 Bari, ItalyDepartment of Interdisciplinary Medicine, Complex Operating Unit of Odontostomatology, Aldo Moro University, Piazza Giulio Cesare 11, 70124 Bari, ItalyDental implants placement in the anterior mandible with flap or flapless technique is a routine procedure and is considered to be safe. However, serious life-threatening complications may occur. We report the first case of massive lingual and sublingual haematoma following postextractive implant placement in the anterior mandible with flapless technique. A 45-year-old female patient underwent placement of four immediately postextractive implants in the anterior mandible using flapless technique. During the procedure, the patient referred intense acute pain and worsening sign of airway obstruction, dysphagia, dyspnea, and speech difficulties. Bimanual compression of the mouth floor, lingual surface of the mandible, and submental skin was maintained for approximately 25 minutes in order to stop the bleeding. Computerized tomography highlighted the massive lingual and sublingual haematoma. The symptoms and signs had almost completely resolved in the next 48 hours. The prevention of these complications is mandatory with clinical and CT analyses, in order to highlight mandibular atrophy and to select carefully the correct length and angulation of bone drilling and to keep more attention to the flapless technique considering the elevation of a lingual mucoperiosteal flap to access the mandibular contour intraoperatively and to protect the sublingual soft tissues and vasculature in high risk cases.http://dx.doi.org/10.1155/2015/839098
spellingShingle Luisa Limongelli
Angela Tempesta
Vito Crincoli
Gianfranco Favia
Massive Lingual and Sublingual Haematoma following Postextractive Flapless Implant Placement in the Anterior Mandible
Case Reports in Dentistry
title Massive Lingual and Sublingual Haematoma following Postextractive Flapless Implant Placement in the Anterior Mandible
title_full Massive Lingual and Sublingual Haematoma following Postextractive Flapless Implant Placement in the Anterior Mandible
title_fullStr Massive Lingual and Sublingual Haematoma following Postextractive Flapless Implant Placement in the Anterior Mandible
title_full_unstemmed Massive Lingual and Sublingual Haematoma following Postextractive Flapless Implant Placement in the Anterior Mandible
title_short Massive Lingual and Sublingual Haematoma following Postextractive Flapless Implant Placement in the Anterior Mandible
title_sort massive lingual and sublingual haematoma following postextractive flapless implant placement in the anterior mandible
url http://dx.doi.org/10.1155/2015/839098
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