Wharton’s duct blockage following anterior mandibular dental implants placement. A retrospective

Objectives: Dental implants placement in the anterior mandible is a very common modality. This area is considered safe for manipulation, though some adjacent anatomical structures should be acknowledged prior to surgery. One of these is the Wharton’s duct orifice, located in the anterior floor of the mouth, adjacent to the surgical field.
Methods: The aim of this study was to find the prevalence of patients demonstrating submandibular chronic obstructive sialadenitis following placement of anterior mandibular implants. A search in the archives of the oral and maxillofacial radiology unit for patients who had anterior mandibular implants placement and were referred for CBCT-sialography of the submandibular glands during 2013-2014 was conducted and reported in this research.
Results: The study included 30 cases of submandibular CBCT-sialography cases, ten of which included implants in the anterior mandible. Among these, two patients were reported to present Warthon’s duct blockage during clinical examination. We present the clinical data of the two cases. Selected images from the sialography-CBCT which demonstrate the blockage are presented
Conclusions: A small percentage of patients show causal relationship between the placement of implants in the anterior mandible and submandibular chronic obstructive sialadenitis. Of note is that the two patients were treated twice with two consequence floor of the mouth surgery, possibly increasing the risk of blockage of the Warthon’s duct. Clinicians should be aware of the possibility of duct orifice blockage following floor of the mouth surgery. Future research will be conducted to search for the prevalence of Warthon’s duct blockage following implants placement in the anterior mandible in a large population