How the simplest dental implant procedure can trigger an extremely serious complication

BMJ Case Rep. 2012 Nov 28:2012:bcr2012007373. doi: 10.1136/bcr-2012-007373.

Abstract

A 62-year-old man came to our attention after an operation in a small dental outpatient clinic where only a single dentist was working. The man was showing complications after insertion of a dental implant in the anterior segments of the mandible. Bleeding led to a slow swelling of the neck with airway obstruction. Only an immediate intervention by a mobile emergency unit and prompt tracheal intubation avoided death by asphyxia. The patient was then transferred to our hospital. We inspected the patient and we performed a CT scan that showed complete airway obstruction. First, we performed a tracheotomy in order to ensure the airway patency and then we identified the source of bleeding: the mylohyoid artery placed anomalously close to the mandible. After clamping and tying the artery, the bleeding resolved. One day after the procedure, the tracheotomy was closed; the patient was discharged after 3 days.

Publication types

  • Case Reports

MeSH terms

  • Airway Obstruction / etiology*
  • Airway Obstruction / therapy
  • Dental Implantation / adverse effects*
  • Drainage
  • Edema / etiology
  • Hematoma / complications*
  • Hematoma / etiology
  • Hematoma / therapy
  • Humans
  • Intubation, Intratracheal
  • Male
  • Middle Aged
  • Postoperative Hemorrhage / complications*
  • Postoperative Hemorrhage / etiology
  • Postoperative Hemorrhage / surgery
  • Tracheotomy