Effect of clinical factors on bacterial contamination of bone chips collected during implant surgery.

PURPOSE: The objective of this study was to investigate the relationship between various clinical factors and bacterial contamination of bone chips (BC) collected during dental implant surgery and to elucidate how bacterial contamination might be minimized. MATERIALS AND METHODS: Implants were installed in 55 partially edentulous patients (36 men and 19 women), among whom the relationship between various clinical factors and bacterial contamination of BC collected by bone trap was investigated in 37. The effect of rinsing with a saline on BC was determined in 18 patients. Number of contaminating microorganisms was expressed as colony-forming units (CFUs). RESULTS: CFUs in the maxilla were lower than those in the mandible (P < 0.01). CFUs at the incisors or canines were lower than those at the premolars or molars (P < 0.01). Logistic regression analysis revealed a relationship between average bacterial count and duration of surgery (odds ratio, 1.046; 95% CI, 1.012-1.081). Rinsing of BC reduced bacterial contamination. CONCLUSION: Duration of surgery is a major clinical factor affecting contamination risk in BC, and rinsing of BC with a sterile saline solution reduces bacterial number.

Variation in arterial supply to the floor of the mouth and assessment of relative hemorrhage risk in implant surgery.

OBJECTIVES: Bleeding in the floor of the mouth during implant surgery is attributed to arterial injuries in the sublingual space: clinicians may injure the submental and sublingual arteries, which originate from the facial and lingual arteries, respectively. This study aimed to clarify the three-dimensional courses of submental and sublingual arteries and their topographic relation to the mandible. MATERIALS AND METHODS: During the gross anatomy course at the Faculty of Dentistry and Graduate School, Niigata University (2009-2011), we investigated the relationship between the courses of submental and sublingual arteries and their dividing patterns of the mylohyoid muscle, sublingual gland, and mandible using 27 human cadavers. RESULTS: The courses of submental and sublingual arteries were divided into four patterns: (1) the sublingual space was supplied by the sublingual artery (type I: 63%), (2) it was supplied by both the sublingual and submental arteries (type II: 5.6%), (3) it was supplied by the submental artery without the sublingual artery (type III: 29.6%), and (4) type III without the deep lingual artery originated from the lingual artery (type IV: 1.8%). In type II, III, and IV, the submental artery perforates the mylohyoid muscle or takes a roundabout route to travel near the surface of the mandible. The percentage occurrence of arteries traveling between the sublingual gland and mandible in type II, III, and IV (55%) is higher than that in type I (8.8%). CONCLUSION: Susceptibility of the submental artery in type II, III, and IV to injury during implant surgery is suggested.