Floor of Mouth Haematoma following Dental Implant Placement: Systematic Review and Case Presentation

Publication date: Available online 21 July 2017
Source:Journal of Oral and Maxillofacial Surgery
Author(s): Catherine Law, Peyman Alam, Farzad Borumandi
PurposeThe authors aim to give a structured review of the reported cases of floor of mouth haematoma during or following dental implantation, the frequent causes and management; with the presentation of a related case.MethodsAn online search of the medical literature was conducted from the year 1990 to 2016. The following search terms were used: floor of mouth haematoma, sublingual haematoma, dental implant haematoma, implant in mandible and complication of dental implant. Abstracts were screened for relevance to the aims of the review. Relevant reports in the English language were included and referenced. The articles were reviewed for patient demographics, implant location, coagulopathy, pre- or postoperative imaging, airway management, treatment of the haematoma and management of the offending implant.ResultsThe literature search identified 25 reported cases. Haemorrhage was caused by perforation of the lingual cortex in 84% of cases (n=21). Airway obstruction resulted in emergency intubation or tracheostomy in 68% of patients (n=17). The majority of cases (n=18, 72%) required surgical management in the hospital setting. The management of the offending implant was reported inconsistently. Out of 17 reported cases, 5 implants had to be removed, 9 remained in situ and in 3 cases the implant placement was abandoned. Only one case performed preoperative three-dimensional imaging prior to implant insertion. We report an additional case with significant floor of mouth haematoma, which required immediate surgical evacuation and haemostasis.ConclusionSerious complications such as floor of mouth haematoma after dental implant insertion may occur which can be potentially life-threatening. Pre-operative 3D imaging helps to visualize the individual mandibular shape which may reduce the incidence of serious complications. If injury to vessels of the floor of the mouth cannot be confidently excluded, further assessment and treatment is recommended before the patient is being discharged.



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