Risk of lingual plate perforation during implant placement in the posterior mandible: a human cadaver study.

Aim: To determine the risk of lingual plate perforations using 2 different implants during implant installation in the posterior mandible, so as to avoid a potentially life-threatening situation and/or a compromise of the success of the surgical procedure.

Materials And Methods: Nine human cadaver jaws and 16 edentulous sites with missing mandibular posterior teeth were used. Upon flap reflection, 3.7 × 10.0 mm and 3.7 × 13 mm Tapered Screw Vent implants were placed in the edentulous sites parallel to the ridge over the center of the alveolar ridge. The occurrence of lingual plate perforations was assessed visually, and the distance of the fenestration from the alveolar ridge crest, if any, was measured.

Results: Nineteen dental implants of each were placed in the second premolar and first molar regions. No lingual concavity perforations were found in all sites, except for a lingual fenestration in 1 first molar site when placing the 3.7 × 10 mm implant (0.053%).

Conclusion: The risk of a lingual cortical plate fenestration or perforation, due to lingual concavity, in an edentulous posterior mandible in the region of the second premolar or first molar was found to be 0.053% if a regular 3.7-mm diameter tapered implant was used. In the presence of significant lingual concavity in the posterior mandible, a smaller regular diameter implant with a tapered design should be considered to avoid a potential fatal damage of vital structures.