Vol 80, No 4 (2021)
Original article
Published online: 2020-10-16

open access

Page views 6793
Article views/downloads 1030
Get Citation

Connect on Social Media

Connect on Social Media

Investigation the anterior mandibular lingual concavity by using cone-beam computed tomography

M. Çitir1, K. Gunduz2, P. Kasap3
Pubmed: 33084005
Folia Morphol 2021;80(4):916-922.

Abstract

Background: In the presence of lingual concavity in the mandible, the cortical perforation and consequently the life-threatening intraoral haemorrhages obstructing the upper respiratory tract may be seen during the surgical intervention. The present study was aimed to determine the prevalence of lingual concavity in the interforaminal region and its relationship with gender and dentate status.
Materials and methods: The images of 106 patients who underwent cone-beam computed tomography (CBCT) between 2016 and 2017 in Department of Dental and Maxillofacial Radiology Department of Faculty of Dentistry of Ondokuz Mayıs University were retrospectively examined. The images were obtained using a Galileos device (98 kVp, 15–30 mA). The bone height and width in interforaminal region and the frequency of lingual concavity were analysed.
Results: Of patients involved in the present study, 42.5% were male and 57.5% were female After the examinations performed, the bone was morphologically classified into four classes as type I lingual concavity, type II inclined to lingual, type III enlarging towards labiolingual and type IV buccal concavity. Type III (77.9%) was the most common type in the anterior region, followed by type II (16.5%), type I (4.7%) and type IV (0.9%). The lingual concavity angle was 76.5 ± 3.69º and the concavity depth was 2.09 ± 0.34 mm.
Conclusions: The lingual concavity can be detected by using the cross-sectional CBCT images and the complications related with lingual cortical perforation can be prevented.

Article available in PDF format

View PDF Download PDF file

References

  1. Badloo K, Levi E, Downie L, et al. Mycotic pseudoaneurysm of the lingual artery: a rare complication of parapharyngeal abscess. J Paediatr Child Health. 2012; 48(11): 1045–1046.
  2. Bolin A, Eliasson S, von Beetzen M, et al. Radiographic evaluation of mandibular posterior implant sites: correlation between panoramic and tomographic determinations. Clin Oral Implants Res. 1996; 7(4): 354–359.
  3. Braut V, Bornstein MM, Lauber R, et al. Bone dimensions in the posterior mandible: a retrospective radiographic study using cone beam computed tomography. Part 1 -- analysis of dentate sites. Int J Periodontics Restorative Dent. 2012; 32(2): 175–184.
  4. Chan HL, Benavides E, Yeh CY, et al. Risk assessment of lingual plate perforation in posterior mandibular region: a virtual implant placement study using cone-beam computed tomography. J Periodontol. 2011; 82(1): 129–135.
  5. Chan HL, Brooks SL, Fu JH, et al. Cross-sectional analysis of the mandibular lingual concavity using cone beam computed tomography. Clin Oral Implants Res. 2011; 22(2): 201–206.
  6. Darriba M, Mendonça-Caridad J. Profuse bleeding and life-threatening airway obstruction after placement of mandibular dental implants. J Oral Maxillofacial Surg. 1997; 55(11): 1328–1330.
  7. Felisati G, Saibene AM, Di Pasquale D, et al. How the simplest dental implant procedure can trigger an extremely serious complication. BMJ Case Rep. 2012; 2012.
  8. Flanagan D. Important arterial supply of the mandible, control of an arterial hemorrhage, and report of a hemorrhagic incident. J Oral Implantol. 2003; 29(4): 165–173, doi: 10.1563/1548-1336(2003)029<0165:iasotm>2.3.co;2.
  9. Frenken JW, Zijderveld SA, van den Bergh JPA, et al. [Haematoma of the floor of the mouth following implant surgery]. Ned Tijdschr Tandheelkd. 2010; 117(1): 17–21.
  10. Givol N, Chaushu G, Halamish-Shani T, et al. Emergency tracheostomy following life-threatening hemorrhage in the floor of the mouth during immediate implant placement in the mandibular canine region. J Periodontol. 2000; 71(12): 1893–1895.
  11. Goodacre C, Bernal G, Rungcharassaeng K, et al. Clinical complications with implants and implant prostheses. J Prosthetic Dentistry. 2003; 90(2): 121–132.
  12. Greenstein G, Cavallaro J, Romanos G, et al. Clinical recommendations for avoiding and managing surgical complications associated with implant dentistry: a review. J Periodontol. 2008; 79(8): 1317–1329.
  13. Hanazawa T, Sano T, Seki K, et al. Radiologic measurements of the mandible: a comparison between CT-reformatted and conventional tomographic images. Clin Oral Implants Res. 2004; 15(2): 226–232.
  14. Herranz-Aparicio J, Marques J, Almendros-Marqués N, et al. Retrospective study of the bone morphology in the posterior mandibular region. Evaluation of the prevalence and the degree of lingual concavity and their possible complications. Med Oral Patol Oral Cir Bucal. 2016; 21(6): e731–e736.
  15. Hofschneider U, Tepper G, Gahleitner A, et al. Assessment of the blood supply to the mental region for reduction of bleeding complications during implant surgery in the interforaminal region. Int J Oral Maxillofac Implants. 1999; 14(3): 379–383.
  16. Hwang HD, Kim JW, Kim YS, et al. Angiographic embolization for hemorrhage control after dental implantation. J Korean Assoc Oral Maxillofac Surg. 2013; 39(1): 27–30.
  17. Kalpidis CDR, Setayesh RM. Hemorrhaging associated with endosseous implant placement in the anterior mandible: a review of the literature. J Periodontol. 2004; 75(5): 631–645.
  18. Kamburoğlu K, Acar B, Yüksel S, et al. CBCT quantitative evaluation of mandibular lingual concavities in dental implant patients. Surg Radiol Anat. 2015; 37(10): 1209–1215.
  19. Krenkel C, Holzner K, Poisel S. [Hematoma of the mouth floor following oral surgery and its anatomical characteristics]. Dtsch Z Mund Kiefer Gesichtschir. 1985; 9(6): 448–451.
  20. Lam EW, Ruprecht A, Yang J. Comparison of two-dimensional orthoradially reformatted computed tomography and panoramic radiography for dental implant treatment planning. J Prosthet Dent. 1995; 74(1): 42–46.
  21. Leong DJM, Chan HL, Yeh CY, et al. Risk of lingual plate perforation during implant placement in the posterior mandible: a human cadaver study. Implant Dent. 2011; 20(5): 360–363.
  22. Locks BJ, Claudino M, Azevedo-Alani L, et al. Evaluation of the bone anatomy of the anterior region of the mandible using cone beam computed tomography. Rev Odontol UNESP. 2018; 47(2): 69–73.
  23. Lofthag-Hansen S, Gröndahl K, Ekestubbe A. Cone-beam CT for preoperative implant planning in the posterior mandible: visibility of anatomic landmarks. Clin Implant Dent Relat Res. 2009; 11(3): 246–255.
  24. Longoni S, Sartori M, Braun M, et al. Lingual vascular canals of the mandible: the risk of bleeding complications during implant procedures. Implant Dent. 2007; 16(2): 131–138.
  25. Loukas M, Kinsella CR, Kapos T, et al. Anatomical variation in arterial supply of the mandible with special regard to implant placement. Int J Oral Maxillofac Surg. 2008; 37(4): 367–371.
  26. Magat G. Radiomorphometric analysis of edentulous posterior mandibular ridges in the first molar region: a cone-beam computed tomography study. J Periodontal Implant Sci. 2020; 50(1): 28–37.
  27. Miller RJ, Edwards WC, Boudet C, et al. Maxillofacial anatomy: the mandibular symphysis. J Oral Implantol. 2011; 37(6): 745–753.
  28. Mordenfeld A, Andersson L, Bergström B. Hemorrhage in the floor of the mouth during implant placement in the edentulous mandible: a case report. Int J Oral Maxillofac Implants. 1997; 12(4): 558–561.
  29. Nickenig HJ, Wichmann M, Eitner S, et al. Lingual concavities in the mandible: a morphological study using cross-sectional analysis determined by CBCT. J Craniomaxillofac Surg. 2015; 43(2): 254–259.
  30. Parnia F, Fard EM, Mahboub F, et al. Tomographic volume evaluation of submandibular fossa in patients requiring dental implants. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2010; 109(1): e32–e36.
  31. Peñarrocha-Diago M, Balaguer-Martí JC, Peñarrocha-Oltra D, et al. Floor of the mouth hemorrhage subsequent to dental implant placement in the anterior mandible. Clin Cosmet Investig Dent. 2019; 11: 235–242.
  32. Pigadas N, Simoes P, Tuffin JR. Massive sublingual haematoma following osseo-integrated implant placement in the anterior mandible. Br Dent J. 2009; 206(2): 67–68.
  33. Quirynen M, Mraiwa N, van Steenberghe D, et al. Morphology and dimensions of the mandibular jaw bone in the interforaminal region in patients requiring implants in the distal areas. Clin Oral Implants Res. 2003; 14(3): 280–285.
  34. Ratschew C, Czernicky W, Watzek G. Lebensbedrohliche Blutung nach Implantation im Unterkiefer. Dtsch Zahnärztl Z. 1994; 49: 65–67.
  35. Romanos GE, Gupta B, Crespi R. Endosseous arteries in the anterior mandible: literature review. Int J Oral Maxillofac Implants. 2012; 27(1): 90–94.
  36. Sammartino G, Prados-Frutos JC, Riccitiello F, et al. The relevance of the use of radiographic planning in order to avoid complications in mandibular implantology: a retrospective study. Biomed Res Int. 2016; 2016: 8175284.
  37. Suomalainen A, Vehmas T, Kortesniemi M, et al. Accuracy of linear measurements using dental cone beam and conventional multislice computed tomography. Dentomaxillofac Radiol. 2008; 37(1): 10–17.
  38. Tal H, Moses O. A comparison of panoramic radiography with computed tomography in the planning of implant surgery. Dentomaxillofac Radiol. 1991; 20(1): 40–42.
  39. Ten Bruggencate CM, Krekeler G, Kraaijehagen HA, et al. Hemorrhage of the floor of the mouth resulting from lingual perforation during implant placement: a clinical report. Int J Oral Maxillofac Implants. 1993; 8: 329–334.
  40. Thomason JM, Feine J, Exley C, et al. Mandibular two implant-supported overdentures as the first choice standard of care for edentulous patients--the York Consensus Statement. Br Dent J. 2009; 207(4): 185–186.
  41. Watanabe H, Mohammad Abdul M, Kurabayashi T, et al. Mandible size and morphology determined with CT on a premise of dental implant operation. Surg Radiol Anat. 2010; 32(4): 343–349.
  42. Woo BM, Al-Bustani S, Ueeck BA. Floor of mouth haemorrhage and life-threatening airway obstruction during immediate implant placement in the anterior mandible. Int J Oral Maxillofac Surg. 2006; 35(10): 961–964.