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Rosano G, Taschieri S et al. Clin Oral Implants Res 2009; 20: 791–795

In the first part of this study, the investigators examined 60 dry mandibles. All had 'at least one lingual foramen at the midline above the genial spines'. In the second part of the study, they carried out macro-anatomical dissection on a further 20 specimens, identifying the lingual arteries following injection of liquid latex mixed with red India ink. In 19 of these, they reported a 'clear vascular perforating branch entering the superior spinal genial foramina as a single vessel' from a sublingual anastomosis. The authors cite 16 incidents of life-threatening bleeds associated with preparation of the implant site, particularly when the drilling depth was 15 mm. In conclusion, they urge 'careful evaluation... before using implants longer than 13 mm in the anterior mandible' and not to place implants at the midline.