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Vital Life-Threatening Hematoma after Implant Insertion in the Anterior Mandible: A Case Report and Review of the Literature

Identifieur interne : 002A05 ( Pmc/Curation ); précédent : 002A04; suivant : 002A06

Vital Life-Threatening Hematoma after Implant Insertion in the Anterior Mandible: A Case Report and Review of the Literature

Auteurs : Eik Schiegnitz [Allemagne] ; Maximilian Moergel [Allemagne] ; Wilfried Wagner [Allemagne]

Source :

RBID : PMC:4628691

Abstract

Dental implant insertion is considered a safe and reliable surgical procedure and severe complications are seldom reported. However, we present a case of a 52-year-old patient who attended our Department of Oral and Maxillofacial Surgery, Johannes Gutenberg University Medical Center, Mainz, with spreading hematoma in the floor of the mouth and acute airway obstruction after insertion of a dental implant in the anterior mandible. The hematoma was removed and submentally drained by a silicon drainage. However, the progressive swelling of the tongue and the floor of the mouth necessitated a temporary tracheotomy for three days. The review of the literature summarizes guidelines for prevention and management of this life-threatening complication.


Url:
DOI: 10.1155/2015/531865
PubMed: 26557390
PubMed Central: 4628691

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PMC:4628691

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<p>Dental implant insertion is considered a safe and reliable surgical procedure and severe complications are seldom reported. However, we present a case of a 52-year-old patient who attended our Department of Oral and Maxillofacial Surgery, Johannes Gutenberg University Medical Center, Mainz, with spreading hematoma in the floor of the mouth and acute airway obstruction after insertion of a dental implant in the anterior mandible. The hematoma was removed and submentally drained by a silicon drainage. However, the progressive swelling of the tongue and the floor of the mouth necessitated a temporary tracheotomy for three days. The review of the literature summarizes guidelines for prevention and management of this life-threatening complication.</p>
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<front>
<journal-meta>
<journal-id journal-id-type="nlm-ta">Case Rep Dent</journal-id>
<journal-id journal-id-type="iso-abbrev">Case Rep Dent</journal-id>
<journal-id journal-id-type="publisher-id">CRID</journal-id>
<journal-title-group>
<journal-title>Case Reports in Dentistry</journal-title>
</journal-title-group>
<issn pub-type="ppub">2090-6447</issn>
<issn pub-type="epub">2090-6455</issn>
<publisher>
<publisher-name>Hindawi Publishing Corporation</publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id pub-id-type="pmid">26557390</article-id>
<article-id pub-id-type="pmc">4628691</article-id>
<article-id pub-id-type="doi">10.1155/2015/531865</article-id>
<article-categories>
<subj-group subj-group-type="heading">
<subject>Case Report</subject>
</subj-group>
</article-categories>
<title-group>
<article-title>Vital Life-Threatening Hematoma after Implant Insertion in the Anterior Mandible: A Case Report and Review of the Literature</article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname>Schiegnitz</surname>
<given-names>Eik</given-names>
</name>
<xref ref-type="aff" rid="I1"></xref>
<xref ref-type="corresp" rid="cor1">
<sup>*</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Moergel</surname>
<given-names>Maximilian</given-names>
</name>
<xref ref-type="aff" rid="I1"></xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Wagner</surname>
<given-names>Wilfried</given-names>
</name>
<xref ref-type="aff" rid="I1"></xref>
</contrib>
</contrib-group>
<aff id="I1">Department of Oral and Maxillofacial Surgery, Johannes Gutenberg University Medical Centre, Augustusplatz 2, 55131 Mainz, Germany</aff>
<author-notes>
<corresp id="cor1">*Eik Schiegnitz:
<email>schiegnitz@gmx.com</email>
</corresp>
<fn fn-type="other">
<p>Academic Editor: Miguel de Araújo Nobre</p>
</fn>
</author-notes>
<pub-date pub-type="ppub">
<year>2015</year>
</pub-date>
<pub-date pub-type="epub">
<day>18</day>
<month>10</month>
<year>2015</year>
</pub-date>
<volume>2015</volume>
<elocation-id>531865</elocation-id>
<history>
<date date-type="received">
<day>6</day>
<month>8</month>
<year>2015</year>
</date>
<date date-type="accepted">
<day>7</day>
<month>10</month>
<year>2015</year>
</date>
</history>
<permissions>
<copyright-statement>Copyright © 2015 Eik Schiegnitz et al.</copyright-statement>
<copyright-year>2015</copyright-year>
<license xlink:href="https://creativecommons.org/licenses/by/3.0/">
<license-p>This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</license-p>
</license>
</permissions>
<abstract>
<p>Dental implant insertion is considered a safe and reliable surgical procedure and severe complications are seldom reported. However, we present a case of a 52-year-old patient who attended our Department of Oral and Maxillofacial Surgery, Johannes Gutenberg University Medical Center, Mainz, with spreading hematoma in the floor of the mouth and acute airway obstruction after insertion of a dental implant in the anterior mandible. The hematoma was removed and submentally drained by a silicon drainage. However, the progressive swelling of the tongue and the floor of the mouth necessitated a temporary tracheotomy for three days. The review of the literature summarizes guidelines for prevention and management of this life-threatening complication.</p>
</abstract>
</article-meta>
</front>
<floats-group>
<fig id="fig1" orientation="portrait" position="float">
<label>Figure 1</label>
<caption>
<p>Elevated floor of the mouth with protruding tongue.</p>
</caption>
<graphic xlink:href="CRID2015-531865.001"></graphic>
</fig>
<fig id="fig2" orientation="portrait" position="float">
<label>Figure 2</label>
<caption>
<p>Cone beam tomography of the implant in region 32.</p>
</caption>
<graphic xlink:href="CRID2015-531865.002"></graphic>
</fig>
<fig id="fig3" orientation="portrait" position="float">
<label>Figure 3</label>
<caption>
<p>Patient postoperative with tracheotomy and extraoral drainage in the chin region.</p>
</caption>
<graphic xlink:href="CRID2015-531865.003"></graphic>
</fig>
<fig id="fig4" orientation="portrait" position="float">
<label>Figure 4</label>
<caption>
<p>Postoperative orthopantogram.</p>
</caption>
<graphic xlink:href="CRID2015-531865.004"></graphic>
</fig>
<table-wrap id="tab1" orientation="portrait" position="float">
<label>Table 1</label>
<caption>
<p>Case reports about vital life-threatening bleeding after implant insertion published in the years 2000–2015.</p>
</caption>
<table frame="hsides" rules="groups">
<thead>
<tr>
<th align="left" rowspan="1" colspan="1">Study</th>
<th align="center" rowspan="1" colspan="1">Age</th>
<th align="center" rowspan="1" colspan="1">Region</th>
<th align="left" rowspan="1" colspan="1">Treatment</th>
</tr>
</thead>
<tbody>
<tr>
<td align="left" rowspan="1" colspan="1">Givol et al., 2000 [
<xref rid="B16" ref-type="bibr">12</xref>
]</td>
<td align="center" rowspan="1" colspan="1">63</td>
<td align="center" rowspan="1" colspan="1">Anterior mandible</td>
<td align="left" rowspan="1" colspan="1">Surgery, tracheotomy</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Niamtu, 2001 [
<xref rid="B17" ref-type="bibr">13</xref>
]</td>
<td align="center" rowspan="1" colspan="1">64</td>
<td align="center" rowspan="1" colspan="1">Anterior mandible</td>
<td align="left" rowspan="1" colspan="1">Tamponade, compression, and tracheotomy</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Weibrich et al., 2002 [
<xref rid="B12" ref-type="bibr">14</xref>
]</td>
<td align="center" rowspan="1" colspan="1">60</td>
<td align="center" rowspan="1" colspan="1">Posterior mandible</td>
<td align="left" rowspan="1" colspan="1">Surgery</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Boyes-Varley and Lownie, 2002 [
<xref rid="B18" ref-type="bibr">15</xref>
]</td>
<td align="center" rowspan="1" colspan="1">50</td>
<td align="center" rowspan="1" colspan="1">Anterior mandible</td>
<td align="left" rowspan="1" colspan="1">Surgery, tracheotomy</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Isaacson, 2004 [
<xref rid="B14" ref-type="bibr">16</xref>
]</td>
<td align="center" rowspan="1" colspan="1">56</td>
<td align="center" rowspan="1" colspan="1">Anterior mandible</td>
<td align="left" rowspan="1" colspan="1">Surgery</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Kalpidis and Konstantinidis, 2005 [
<xref rid="B13" ref-type="bibr">17</xref>
]</td>
<td align="center" rowspan="1" colspan="1">43</td>
<td align="center" rowspan="1" colspan="1">Posterior mandible</td>
<td align="left" rowspan="1" colspan="1">Tamponade, compression</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Budihardja et al., 2006 [
<xref rid="B19" ref-type="bibr">18</xref>
]</td>
<td align="center" rowspan="1" colspan="1">80</td>
<td align="center" rowspan="1" colspan="1">Anterior mandible</td>
<td align="left" rowspan="1" colspan="1">Tracheotomy</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Woo et al., 2006 [
<xref rid="B20" ref-type="bibr">19</xref>
]</td>
<td align="center" rowspan="1" colspan="1">47</td>
<td align="center" rowspan="1" colspan="1">Anterior mandible</td>
<td align="left" rowspan="1" colspan="1">Surgery, tracheotomy</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">de Vera et al., 2008 [
<xref rid="B21" ref-type="bibr">20</xref>
]</td>
<td align="center" rowspan="1" colspan="1">53</td>
<td align="center" rowspan="1" colspan="1">Anterior mandible</td>
<td align="left" rowspan="1" colspan="1">Surgery</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Ferneini et al., 2009 [
<xref rid="B22" ref-type="bibr">21</xref>
]</td>
<td align="center" rowspan="1" colspan="1">77</td>
<td align="center" rowspan="1" colspan="1">Posterior mandible</td>
<td align="left" rowspan="1" colspan="1">Observation</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Pigadas et al., 2009 [
<xref rid="B23" ref-type="bibr">22</xref>
]</td>
<td align="center" rowspan="1" colspan="1">71</td>
<td align="center" rowspan="1" colspan="1">Anterior mandible</td>
<td align="left" rowspan="1" colspan="1">Surgery, tracheotomy</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Dubois et al., 2010 [
<xref rid="B24" ref-type="bibr">23</xref>
]</td>
<td align="center" rowspan="1" colspan="1">76 and 62</td>
<td align="center" rowspan="1" colspan="1">Anterior mandible</td>
<td align="left" rowspan="1" colspan="1">Case 1: surgery, tracheotomy;
<break></break>
Case 2: surgery, tracheotomy</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Hong and Mun, 2011 [
<xref rid="B7" ref-type="bibr">7</xref>
]</td>
<td align="center" rowspan="1" colspan="1">54</td>
<td align="center" rowspan="1" colspan="1">Posterior maxilla </td>
<td align="left" rowspan="1" colspan="1">Surgery</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Felisati et al., 2012 [
<xref rid="B25" ref-type="bibr">24</xref>
]</td>
<td align="center" rowspan="1" colspan="1">62</td>
<td align="center" rowspan="1" colspan="1">Anterior mandible</td>
<td align="left" rowspan="1" colspan="1">Surgery, tracheotomy</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Lee et al., 2012 [
<xref rid="B26" ref-type="bibr">25</xref>
]</td>
<td align="center" rowspan="1" colspan="1">69</td>
<td align="center" rowspan="1" colspan="1">Anterior mandible</td>
<td align="left" rowspan="1" colspan="1">Surgery</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Hwang et al., 2013 [
<xref rid="B27" ref-type="bibr">26</xref>
]</td>
<td align="center" rowspan="1" colspan="1">53</td>
<td align="center" rowspan="1" colspan="1">Anterior mandible</td>
<td align="left" rowspan="1" colspan="1">Surgery</td>
</tr>
<tr>
<td align="left" rowspan="1" colspan="1">Sakka and Krenkel, 2013 [
<xref rid="B28" ref-type="bibr">27</xref>
]</td>
<td align="center" rowspan="1" colspan="1">66</td>
<td align="center" rowspan="1" colspan="1">Anterior mandible</td>
<td align="left" rowspan="1" colspan="1">Surgery</td>
</tr>
</tbody>
</table>
</table-wrap>
</floats-group>
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