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CC BY-NC-ND 4.0 · European Dental Research and Biomaterials Journal
DOI: 10.1055/s-0043-1776284
Literature Review/Case Report

Clinical Case and Literature Review of a Potentially Life-Threatening Complication Derived from Mouth Floor Hematoma after Implant Surgery

Beatriz Carreira-Nestares
1   Oral Surgery and Implantology, Madrid, Spain
,
Irene Urquiza-Fornovi
2   Department of Oral and Maxillofacial Surgery, Hospital 12 de Octubre, Madrid, Spain
,
Manuel Carlos Carreira-Delgado
3   Department of General Surgery, Hospital Universitario de Vigo, Vigo, Spain
,
Ramón Gutierrez-Díaz
2   Department of Oral and Maxillofacial Surgery, Hospital 12 de Octubre, Madrid, Spain
,
Gregorio Sánchez-Aniceto
2   Department of Oral and Maxillofacial Surgery, Hospital 12 de Octubre, Madrid, Spain
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Abstract

The placement of dental implants is a safe and predictable procedure when performed by qualified staff. The incidence of complications derived from this type of surgery has increased due to the greater number of patients undergoing dental rehabilitation treatments in recent years. Floor of the mouth hematoma is a rare, but potentially fatal, complication that every oral surgeon should recognize for early diagnosis. As part of the clinical case presented here, two implants were removed and a hemorrhage in the floor of the mouth was found, which required an urgent intervention to control the bleeding. Two independent researchers conducted an electronic search of the available scientific evidence in relation to bleeding of the floor of the mouth in dental implant surgery. The research included references, which were written in English or Spanish, and published up to December 2022. Case reports, case series, systematic reviews, and meta-analysis were part of the inclusion criteria. Sixty-four bibliographic references were identified, and 39 full-text articles were selected. There were 30 cases of floor of the mouth hematoma in relation to implant surgery. In 13 patients the main location was interforaminal, in 5 in the canine area, in 6 in the incisor area, and in 6 in the molar premolar region. All cases were caused by perforation of the cortical bone or surgical manipulation (disruption of the periosteum, perforation of the sublingual mucosa by the stiff suture). The sublingual artery was most frequently involved. The clinical sign observed in all cases was elevation of the floor of the mouth. In 21 of the cases there was airway involvement, so the main treatment was intubation or tracheostomy. Floor of the mouth hematoma may be one complication associated with implant surgery. Given the seriousness of this clinical picture, early detection by the dentist and hospital referral are essential. Warning signs are sudden swelling of the floor of the mouth or submandibular area, accompanied by dysphagia and dyspnea.

Keywords

dental implant - hematoma - hemorrhage - floor of mouth

Ethical Responsibilities

Protection of people and animals: The authors state that no experiments have been conducted on humans or animals for this research.


Confidentiality of data: The authors state that they have followed their workplace's protocols on the publication of patient data.


Right to privacy and informed consent: The authors obtained the informed consent of the patient referred to in the article. This document is in the possession of the corresponding author.


Authors' Contributions

B.C.N contributed for manuscript and literature review writing, selection of studies for inclusion in the narrative review, and final approval. M.C.C.D contributed for literature review and selection of studies for inclusion, critical review of the manuscript, and final approval. I.U.F contributed for writing of the clinical case, critical review of the manuscript, and final approval. R.G.D contributed for Maxillofacial surgeon who operated on the patient and resolved the complication described in the clinical case, writing the clinical case, critical review of the manuscript, and final approval. G.S.A. did the critical review of the manuscript and final approval.


Summary Box

What is known:


Life-threatening complications during implant surgery are rare, and few articles have been published.


What this article adds:


The manuscript describes a case of hematoma of the floor of the mouth during explantation surgery for two implants. This is a complication that could be more prevalent than for implantation due to its difficulty. Nevertheless, it is reported less frequently in the literature. A literature review and unification of all reported cases was conducted and presented in this study.




Publication History

Article published online:
18 February 2024

© 2024. European Dental Research and Biomaterials Journal. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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