Department of Oral and Maxillofacial Surgery, Isala klinieken Zwolle, The Netherlands.
Int J Oral Maxillofac Surg. 2010 Apr;39(4):412-5. doi: 10.1016/j.ijom.2009.07.062. Epub 2010 Jan 15.
Placement of dental implants in the interforaminal region of the edentulous mandible is considered a safe and routine surgical procedure. Hemorrhage in the floor of the mouth has been reported as a rare, potentially life-threatening complication related to the placement of implants in this region. In this case report the authors present an immediate and a delayed case of massive bleeding in the floor of the mouth after implant placement. This highly vascularized region is vulnerable and bleeding can be induced easily by instrumentation, causing a vascular trauma, usually by perforation of lingual periostium. In almost all cases the expanding hematoma formation starts during surgery. The effect of the vasoconstrictive agent in the local anesthesic combined with an injury of the lingual arterio-venous plexus can result in delayed swelling, causing respiratory distress through obstruction of the upper airways.
将牙种植体放置在下颌无牙区的间隙中被认为是一种安全且常规的手术。在该区域放置种植体后，出现口底出血是一种罕见的、可能危及生命的并发症。在本病例报告中，作者介绍了两例即刻和延迟发生的种植体放置后口底大出血的病例。这个高度血管化的区域很脆弱，器械操作很容易引起出血，导致血管创伤，通常是舌骨骨膜穿孔。几乎所有情况下，血肿形成都是在手术过程中开始的。局麻药中的血管收缩剂的作用加上舌动静脉丛的损伤，可导致延迟性肿胀，通过上呼吸道阻塞导致呼吸困难。
