VARIABILITY OF SUBMENTAL AND SUBLINGUAL ARTERIES IN THE SUBLINGUAL SPACE AND RELATIVE HAEMORRHAGE RISK IN ORAL SURGERY

Abstract

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Aim. This study aimed to demonstrate the anatomical variations of the submental and sublingual arteries (SA and SLA) in the sublingual space. This region is subjected to various surgical procedures, such as implant placement and tori mandibularis removal, which rarely may lead to extensive haemorrhage. Material and Methods. A Medline (PubMed) and Science Direct literature search was made regarding the SA and SLA variants along with the severe bleeding complications in oral surgery published in English up until December 2017. Inclusion criteria: cadaveric and clinical studies. Exclusion criteria: patients receiving anticoagulation treatment. Results and Discussion. The SA is the largest of the four cervical branches arising from the facial artery (FA). However, a distribution from the external carotid artery has also been reported. SA is mainly originated superficially to the submandibular gland or between the superior border of the gland and the body of the mandible. The SLA is given off the lingual artery, the FA and the SA in the anterior border of the hyoglossus muscle. The sublingual space can be supplied by seven different arterial branching patterns. The latter are formed either independently from the SA and the SLA, or their common contribution. The anterior mandible has the largest bleeding susceptibility in the canine area mainly due to lingual cortical plate perforation. Conclusions. The present study provides precise data on the course of the SA and the SLA in the sublingual space, which will be of clinical importance during oral surgery of the anterior mandible and especially in implant placement.