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Anatomic Basis of Dental Implant Complications

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Complex Dental Implant Complications
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Abstract

This is a review of the pertinent surgical anatomy of the maxillofacial region as it relates to common complications seen in the surgical placement of implants. The range of complications as evidenced in this textbook can be substantial: from bone loss due to infection, to bleeding, hematomas, sinus injury, nerve injury, and osseous fractures. This chapter will also include a section in the aberrant placement or migration of implants hence a review of fascial spaces is covered. Some management recommendations will be covered in dealing with vascular and neurologic injuries and need repeating as they are the most morbid and worrisome. John Hunter is said to believe that surgery is anatomy. Obtaining excellence in surgical skills in trainees comes with time, practice, and respect (knowledge) of anatomy. A textbook like this, filled with many combinations of troubling outcomes, requires the reader to review and remember the very complex anatomy of the head and neck. This chapter is not meant to substitute the large body of work in Head and Neck Anatomy, but we hope to provide an anatomic key to common recurring problems. Knowledge of the osseous, vascular, neurologic, and soft tissue structures intimately related to the maxillofacial region in relation to implant therapy should be intuitively embedded in the surgeon’s hands as they meander through all possible procedures.

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References

  1. Devadas D, Pillay M, Sukumaran TT. A cadaveric study on variations in branching pattern of external carotid artery. Anat Cell Biol. 2018;51(4):225–31.

    Article  Google Scholar 

  2. Hansen JT, Netter FH, Machado CAG. Netters clinical anatomy. Philadelphia, PA: Elsevier; 2019.

    Google Scholar 

  3. Seki S, Sumida K, Yamashita K, Baba O, Kitamura S. Gross anatomical classification of the courses of the human lingual artery. Surg Radiol Anat. 2016;39(2):195–203. https://doi.org/10.1007/s00276-016-1696-8.

    Article  PubMed  Google Scholar 

  4. Joo W, Funaki T, Yoshioka F, Rhoton AL. Microsurgical anatomy of the infratemporal fossa. Clin Anat. 2013;26(4):455–69. https://doi.org/10.1002/ca.22202.

    Article  PubMed  Google Scholar 

  5. Forman G. Presenile mandibular atrophy: Its aetiology, clinicalevaluation and treatment by jaw augmentation. Br J Oral Surg. 1976;14(1):47–56. https://doi.org/10.1016/0007-117X(76)90093-7.

    Article  PubMed  Google Scholar 

  6. Yu S-K, Lee M-H, Park BS, Jeon YH, Chung YY, Kim H-J. Topographical relationship of the greater palatine artery and the palatal spine. Significance for periodontal surgery. J Clin Periodontol. 2014;41:908–13. https://doi.org/10.1111/jcpe.12288.

    Article  PubMed  Google Scholar 

  7. Balaguer-Marti JC, Penarrocha-Oltra D, Balaguer-Martinez J, et al. Immediate bleeding complications in dental implants: a systematic review. Med Oral Patol Oral Cir Bucal. 2015;20:e231.

    Article  Google Scholar 

  8. Law C, Alam P, Borumandi F. Floor-of-mouth hematoma following dental implant placement: literature review and case presentation. J Oral Maxillofac Surg. 2017;75(11):2340–6. https://doi.org/10.1016/j.joms.2017.07.152.

    Article  PubMed  Google Scholar 

  9. Tagaya A, Matsuda Y, Nakajima K, Seki K, Okano T. Assessment of the blood supply to the lingual surface of the mandible for reduction of bleeding during implant surgery. Clin Oral Implants Res. 2009;20(4):351–5. https://doi.org/10.1111/j.1600-0501.2008.01668.x.

    Article  PubMed  Google Scholar 

  10. Bathla G, Hegde A. The trigeminal nerve: an illustrated review of its imaging anatomy and pathology. Clin Radiol. 2013;68(2):203–13. https://doi.org/10.1016/j.crad.2012.05.019.

    Article  PubMed  Google Scholar 

  11. Alali Y, Mangat H, Caminiti M. Lingual nerve injury: surgical anatomy and management. Oral Health. 2018;2018:9.

    Google Scholar 

  12. Sittitavornwong S, Babston M, Denson D, Zehren S, Friend J. Clinical anatomy of the lingual nerve: a review. J Oral Maxillofac Surg. 2017;75(5):926.e1–9. https://doi.org/10.1016/j.joms.2017.01.009.

    Article  Google Scholar 

  13. Kiesselbach JE, Chamberlain JG. Clinical and anatomic observations on the relationship of the lingual nerve to the mandibular third molar region. J Oral Maxillofac Surg. 1984;42(9):565–7. https://doi.org/10.1016/0278-2391(84)90085-5.

    Article  PubMed  Google Scholar 

  14. Pogrel MA, Dorfman D, Fallah H. The anatomic structure of the inferior alveolar neurovascular bundle in the third molar region. J Oral Maxillofac Surg. 2009;67(11):2452–4. https://doi.org/10.1016/j.joms.2009.06.013.

    Article  PubMed  Google Scholar 

  15. Okumuş Ö, Dumlu A. Prevalence of bifid mandibular canal according to gender, type and side. J Dent Sci. 2019;14(2):126–33. https://doi.org/10.1016/j.jds.2019.03.009.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Chavez-Lomeli ME, Mansilla Lory J, Pompa JA, Kjaer I. The human mandibular canal arises from three separate canals innervating different tooth groups. J Dent Res. 1996;75:1540e4.

    Article  Google Scholar 

  17. Park HD, Min CK, Kwak HH, Youn KH, Choi SH, Kim HJ. Topography of the outer mandibular symphyseal region with reference to the autogenous bone graft. Int J Oral Maxillofac Surg. 2004;33:781–5.

    Article  Google Scholar 

  18. Pereira RS, Pavelski MD, Griza GL, Boos FBJD, Hochuli-Vieira E. Prospective evaluation of morbidity in patients who underwent autogenous bone-graft harvesting from the mandibular symphysis and retromolar regions. Clin Implant Dent Relat Res. 2019;21(4):753–7. https://doi.org/10.1111/cid.12789.

    Article  PubMed  Google Scholar 

  19. Yamamoto R, Nakamura A, Ohno K, Michi K. Relationship of the mandibular canal to the lateral cortex of the mandibular ramus as a factor in the development of neurosensory disturbance after bilateral sagittal split osteotomy. J Oral Maxillofac Surg. 2002;60:490–5.

    Article  Google Scholar 

  20. Jack-Min Leong D, Li J, Moreno I, Wang H. Distance between external cortical bone and mandibular canal for harvesting ramus graft: a human cadaver study. J Periodontol. 2010;81:239–43.

    Article  Google Scholar 

  21. Neugebauer J, Ritter L, Mischkowski RA, Dreiseidler T, Scherer P, Ketterle M, Rothamel D, Zöller JE. Evaluation of maxillary sinus anatomy by cone-beam CT prior to sinus floor elevation. Int J Oral Maxillofac Implants. 2010;25:258–65.

    PubMed  Google Scholar 

  22. Kqiku L, Biblekaj R, Weiglein AH, Kqiku X, Städtler P. Arterial blood architecture of the maxillary sinus in dentate specimens. Croat Med J. 2013;54(2):180–4. https://doi.org/10.3325/cmj.2013.54.180.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Almasri M, El-Hakim M. Fracture of the anterior segment of the atrophic mandible related to dental implants. Int J Oral Maxillofac Surg. 2012;41(5):646–9. https://doi.org/10.1016/J.IJOM.2012.01.004.

    Article  PubMed  Google Scholar 

  24. Meijer HJA, Raghoebar GM, Visser A. Mandibular fracture caused by peri-implant bone loss: report of a case. J Periodontol. 2003;74(7):1067–70. https://doi.org/10.1902/jop.2003.74.7.1067.

    Article  PubMed  Google Scholar 

  25. McKenzie WS, Rosenberg M. Iatrogenic subcutaneous emphysema of dental and surgical origin: a literature review. J Oral Maxillofac Surg. 2009;67:1265–8.

    Article  Google Scholar 

  26. Al-Ghurabi ZH, Al-Bahrani ZM. Radiographic assessment of nasopalatine canal using cone beam computed tomography. J Craniofac Surg. 2020;31(1):e4–6. https://doi.org/10.1097/scs.0000000000005805.

    Article  PubMed  Google Scholar 

  27. Ueda M, Nakamori K, Shiratori K, Igarashi T, Sasaki T, Anbo N, et al. Clinical signifi- cance of computed tomographic assessment and anatomic features of the inferior alveo- lar canal as risk factors for injury of the inferior alveolar nerve at third molar surgery. J Oral Maxillofac Surg. 2012;70:514–20.

    Article  Google Scholar 

  28. Chrcanovic BR, Machado VC, Gjelvold B. A morphometric analysis of the mandibular canal by cone beam computed tomography and its relevance to the sagittal split ramus osteotomy. Oral Maxillofac Surg. 2016;20:183–90.

    Article  Google Scholar 

  29. Pippi R, Spota A, Santoro M. Medicolegal considerations involving iatrogenic lingual nerve damage. J Oral Maxillofac Surg. 2018;76(8):1651.e1–1651.e13. https://doi.org/10.1016/j.joms.2018.03.020.

    Article  Google Scholar 

  30. Levine MH, Goddard AL, Dodson TB. Inferior alveolar nerve canal position: a clinical and radiographic study. J Oral Maxillofac Surg. 2007;65:470–4.

    Article  Google Scholar 

  31. Bornstein MM, Balsiger R, Sendi P, von Arx T. Morphology of the nasopalatine canal and dental implant surgery: a radiographic analysis of 100 consecutive patients using limited cone-beam computed tomography. Clin Oral Implants Res. 2011;22(3):295–301.

    Article  Google Scholar 

  32. Arrocha DP, Cel E, Guirado JLC, Canullo L, Peñarrocha M. Implants placed in the nasopalatine canal to rehabilitate severely atrophic maxillae: a retrospective study with long follow-up. J Oral Implantol. 2014;40(6):699–706. https://doi.org/10.1563/AAID-JOI-D-12-00145.

    Article  Google Scholar 

  33. Welcker K, Nakashima M, Branscheid D. Aspiration of dental implant – reasons, management and prevention. Pneumologie. 2005;59(3):174–7. https://doi.org/10.1055/s-2004-830210.

    Article  PubMed  Google Scholar 

  34. Sussman HI. Tooth devitalization via implant placement: a case report. Periodontal Clin Investig. 1998;20:22–4.

    PubMed  Google Scholar 

  35. Romanos GE, Gupta B, Crespi R. Endosseous arteries in the anterior mandible: literature review. Int J Oral Maxillofac Implants. 2012;27(1):90–4.

    PubMed  Google Scholar 

  36. Kheir M, Sheikhi M. Assessment of the anterior loop of mental nerve in an Iranian population using cone beam computed tomography scan. Dent Res J (Isfahan). 2017;14(6):418–42.

    Article  Google Scholar 

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Correspondence to Marco F. Caminiti .

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Caminiti, M.F., Kierce, J. (2020). Anatomic Basis of Dental Implant Complications. In: Bagheri, S., Khan, H., Stevens, M. (eds) Complex Dental Implant Complications . Springer, Cham. https://doi.org/10.1007/978-3-030-47012-8_4

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  • DOI: https://doi.org/10.1007/978-3-030-47012-8_4

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-47011-1

  • Online ISBN: 978-3-030-47012-8

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