Hemorrhage Secondary to Interforamina Implant Surgery: Anatomical Considerations
Notice bibliographique
Résumé
Introduction Dental implants are commonly used to replace missing teeth in the anterior mandible. However, this area is richly vascularized by the sublingual and submandibular arteries, which are branches of the lingual and facial arteries respectively. The pathways of these arteries are variable, as evidenced by the variability of the lingual foramina that they traverse through. These foramina are located in the interforaminal area, which is on the lingual surface of the anterior mandible where the genial tubercles are found. Placement of implants in the interforaminal area can lead to hemorrhage, the results of which can lead to serious complications including swelling of the submandibular floor and tongue, as well as obstruction of the airways. Objectives The objective of this research was to characterize variations in the sublingual and submandibular arteries. Secondarily, we will enumerate and describe the lingual foramina through which these arteries pass. Methods The study was performed on both dry mandibles and cadaveric samples. To characterize the variability in the lingual foramina, 50 dry mandibles were used and measurements of the lingual foramina in the interforaminal area were recorded. These measurements included the diameter of the foramina, the location of the foramina relative to the superior and inferior borders of the mandible, and their frequency of occurrence bilaterally on the mandible. The location of foramina was measured as a ratio of the distance from the superior border of the mandible over the total height of the anterior mandible, in order to account for differences in mandibular heights between specimens. To characterize paths and branching patterns of the sublingual and submandibular arteries, 15 cadaveric heads will be dissected. The arteries will then be examined for variations in their branching, asymmetry, and point of entry into the mandible (distance from superior portion of mandibular bone). Results Of the lingual foramina measured, 51% (20/39) were clustered 55–65% below the internal superior surface of the mandible. However, there was large variation in this data, with lingual foramina occurring anywhere from 30% below the internal superior border of the mandibular bone to 70% of the distance below. Additionally, 26/39 (67%) of foramina were found on the lower half of the mandibular bone surface. Examination of foramina symmetry suggest significantly more were found on the left side (Left = 2.3 ± 1.1) as opposed to the right (1.4 ± 1.1) (P=0.021). Conclusion Within the limits of this study more foramina exist on the left half of the lingual side of the anterior mandible than on the right which could imply a greater blood supply to that region. Further investigations are being carried out to determine the distribution of the sublingual and submandibular artery branches in the interforaminal area. Possible avenues will use CBCT or ultrasound in patients to define and locate these arteries as they enter the mandible, as this is difficult to see in embalmed cadavers. Enhanced knowledge of the arterial supply and variation of this area of the mandible will guide clinical practice in the future and can help avoid complication.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,002 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,002 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,001 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».