The Journal of the American Dental Association
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J Am Dent Assoc, Vol 135, No 2, 168-172.
© 2004 American Dental Association
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CLINICAL PRACTICE

CASE REPORT

Sublingual hematoma formation during immediate placement of mandibular endosseous implants



TIMOTHY J. ISAACSON, D.D.S.

Background. Sublingual hematoma during placement of mandibular endosseous dental implants is a rare, but potentially life-threatening, complication. The development of a sublingual hematoma during a dental procedure may result in the need for acute airway management, including intubation or even emergent tracheostomy. Dental implants are becoming a well-accepted treatment, and thousands of implants are placed every year by general practitioners and specialists, with few adverse sequelae. Clinicians rarely discuss this complication with patients before surgery, and no reports of death secondary to sublingual hematoma formation have been published. The incidence of this event is difficult to ascertain, and only a few cases have been reported.

Case Description. A 56-year-old man with severe caries underwent multiple mandibular tooth extractions and alveoloplasty and received endosseous implants. During the surgical procedure, the patient developed a large sublingual hematoma that required hospitalization.

Clinical Implications. Practitioners who perform implant surgery in the anterior mandible should notify patients of the potential risk of sublingual hematoma formation, and be able to manage acute airway issues that may result from this complication.




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