Iatrogenic penetration of the mouth floor during mandibular molar extraction: A case of protracted bleeding in an emergency department and clinico-anatomical considerations.

Abstract

Iatrogenic perforation of the lingual cortical plate of the mandible is uncommon but it may result in injuries to various adjacent structures such as the lingual nerve, sublingual gland, submandibular duct, deep lobe of the submandibular gland, and branches of rich anastomosing plexus supplying the floor of the mouth (FOM). The aim of this article was to highlight an unusual case of protracted postoperative bleeding that was occurred due to a FOM injury during an attempt to extract a mandibular second molar. Various anatomical considerations with clinical relevance were summarized too. Even small and superficial injuries of FOM should be not misjudged but be carefully monitored, since there is a potential risk for significant haemorrhage and hematoma formation leading to airway obstruction.