The potential for facial artery injury during mandibular third molar extraction. An anatomical study using contrast-enhanced computed tomography

Yohei Takeshita, Soichiro Ibaragi, Hirokazu Yutori, Jingo Kusukawa, R. Shane Tubbs, Toshiyuki Kawazu, Junichi Asaumi, Joe Iwanaga

Research output: Contribution to journalArticlepeer-review

Abstract

The purpose of this study was to evaluate the risk of injury to the facial (FA) and related arteries during mandibular third molar (MTM) extraction using contrast-enhanced computed tomography (CE-CT). CE-CT images of the MTM region were retrospectively reviewed. The area of the MTM was equally divided into three zones in the coronal images from mesial to distal, that is, zone 1, zone 2, and zone 3. The FA, submental artery (SMA), and sublingual artery (SLA) were identified. The distance from the mandible to FA, SMA, and SLA and the diameter of the FA, SMA, and SLA was measured in three zones, respectively. The thickness of the facial soft tissues and width of the mandible were measured at their maximum. The mean distance from the FA to the buccal cortical bone in zone 1, zone 2 and zone 3 was 2.24 mm, 2.39 mm and 1.67 mm, respectively. The SMA and SLA were found to be distal to the mandible. The mean diameter of the FA was 1.26 mm in males and 1.04 mm in females, respectively (p < 0.0001). The distance between the FA and buccal cortical bone of the mandible, and the patients' weight showed moderate correlation in zones 1 and 2. Based on our findings, the FA can be damaged if the surgical invasion reaches the facial soft tissues during MTM surgery. The patients' weight might be a good predictor for FA injury when CE-CT is not available.

Original languageEnglish
Pages (from-to)1215-1223
Number of pages9
JournalClinical Anatomy
Volume34
Issue number8
DOIs
Publication statusAccepted/In press - 2021
Externally publishedYes

Keywords

  • contrast-enhanced computed tomography
  • facial artery
  • iatrogenic injury
  • tooth removal
  • wisdom tooth

ASJC Scopus subject areas

  • Anatomy
  • Histology

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