Implant dentistry is considered to be a safe and routine surgical procedure. However, cases of life-threatening hematoma of the floor of the mouth resulting in airway obstruction were previously reported as a complication of implant placement in the anterior mandible. Massive bleeding in this anatomical site may be caused by perforating the lingual cortex and/or damaging the lingual perimandibular vessels. In the long term, dental implants can fail, mainly due to peri-implantitis, and must be removed. Explantation procedure may occasionally become a complex challenge, with a risk for various complications.
Case report: This report presents the first case of life-threatening hematoma of the floor of the mouth, as a complication secondary to a failed attempt of dental implant removal at the anterior mandible. The proximity of the implant to the lingual vascular canal might have served as a cause for vascular damage during explantation.
Conclusions: Implant removal complications are scarcely described in the literature. Nonetheless, damaging blood vessels during explantation should not be underestimated. Computed tomography (CT) may be of value not only in preoperative implant planning but also before implant removal in jeopardized anatomical zones such as the anterior mandible. Lingual vascular canals should be looked for on computed tomography scans.
Keywords: airway, anterior mandible, bleeding, explantation, hematoma, implant removal
