Osteotomy preparation: safety of vascular channels?

Every time I plan for implants, I see blood vessels crossing the lingual cortical plate in the mandible. I am always worried about perforating these vessels and causing a lingual/sublingual hematoma. If I do not perforate the lingual cortical plate, how safe would it be to place implants near these vessels? When I encountered this situation, I have noticed a minute hemorrhage under the tongue measuring about 2- 4 mm.  Can you make some recommendations how to avoid hemorrhage from these vessels?



4 thoughts on “Osteotomy preparation: safety of vascular channels?

  1. Mark Bourcier says:

    The only way to avoid them is to identify them on CBCT and use guided surgery to guide your osteotomy away from them.

    (0)
  2. Alejandro Berg says:

    If you are worried about perforating, fully guided surgery is for you. I would recomend Paltop.
    The vascular channels are of no major concern, except in blood disorder carrying patients and even then…
    Cheers

    (0)
  3. JLWperio says:

    Vascular channels from the lingual plate of the mandible (especially the anterior) are of considerable concern in any patient . Avoid them with CBCT; plan proper placement ahead of time or penetration of such a vessel can create a rapidly expanding sublingual hematoma which can compromise the patient’s airway.

    (0)

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