Immediate bleeding complications in dental implants: A systematic review

OBJECTIVE A review is made of the immediate or immediate postoperative bleeding complications in dental implants, with a view to identifying the areas of greatest bleeding risk, the causes of bleeding, the length of the implants associated with bleeding, the most frequently implicated blood vessels, and the treatments used to resolve these complications. MATERIAL AND METHODS A Medline (PubMed) and Embase search was made of articles on immediate bleeding complications in dental implants published in English up until May 2014. INCLUSION CRITERIA studies in humans subjects with severe bleeding immediately secondary to implant placement, which reported the time until the hemorrhage, the implant lenght, the possible cause of bleeding and the treatment. EXCLUSION CRITERIA patients receiving anticoagulation treatment. RESULTS Fifteen articles met the inclusion criteria. The area with the largest number of bleeding complications corresponded to the mandibular canine. The cause of bleeding was lingual cortical bone perforation during implant placement, with damage to the sublingual artery. The implants associated with bleeding were those measuring 15 mm in length or more. Management focused on securing the airway (with intubation or tracheostomy if necessary), with bleeding control. CONCLUSIONS It's important to pay special attention when the implants are placed in the mandibular anterior zone, especially if long implants are used. The most frequently cause of bleeding was the perforation of the lingual plate. Treatment involves securing the airway, with bleeding control.