Anatomical variation in arterial supply of the mandible with special regard to implant placement

The aim of this study was to explore the anatomical variation of the sublingual artery in relation to the mandible, and provide preoperative information to avoid hemorrhagic complications of implant placement. One hundred adult human cadavers injected with red latex were examined. The main arterial supply to the anterior mandible is the sublingual artery as a branch of the lingual or submental artery. This artery exhibited three notable branches, termed ascending, middle and descending. In 73% of cases the sublingual artery originated from the lingual artery to give ascending (72%), middle (98%) and descending (54%) branches. In the remaining 27 cases the sublingual artery originated from the submental artery, giving ascending (69%), middle (98%) and descending (50%) branches. It was possible to identify anastomotic patterns between the sublingual and inferior labial arteries in 52%, sublingual and submental arteries in 40%, and submental and inferior labial arteries in 54% of cases. Of the branches supplying the floor and gingival mucosa of the anterior mandible, mucosal branches of the sublingual were found in the territory of the lateral incisor in 72%, canine in 62%, and first premolar in 81% of cases. Disruption of these anastomoses by implant placement could cause life-threatening hemorrhages. These data should prove useful in the placement of mandibular implants.