The lingual foramen as a potential anatomical complication for dental implant placement in the anterior mandible

Abstract

The purpose of this article is to assess the incidence of lingual foramina and associated vasculature in the anterior mandible to improve the understanding of their locations for dental implant placement. Intra-operative bleeding can be a significant complication. Pre-surgical assessment of the surgical site should be performed to identify anatomical landmarks. This can prevent a potential life-threatening haemorrhage that may compromise the airway.  Nutrient canals can occur in the anterior mandible and have been reported to cause significant bleeding if violated. Using cone beam computerized tomography (CBCT) this study defines the anatomical locales in the mandible. CBCTs of 70 patients were obtained and examined for the presence of lingual foramina. The distance of lingual foramina to the inferior border of the mandible, bifurcations and propensity for the midline were assessed. Lingual foramina were found in all of the examined mandibles with variable configurations. CBCT may be important in planning for surgical procedures in the anterior mandible to prevent an unexpected hemorrhage. The present study is limited by its sample size, method of assessment and confinement to a geographical population. The results will need validation in further studies which may incorporate multiple assessment techniques and a larger sample size with to include greater geographical distribution. Future work may seek to describe emanations of the terminus of the sublingual artery.