Ranula as a Complication of Dental Implant Therapy: A Case Report and Systematic Review

Introduction. Ranulas are pseudocysts caused by saliva retention or extravasation from the sublingual or submandibular gland. Trauma is believed to be the most common cause of ranula formation, but it can also result from ductal obstruction or congenital malformation. Ranulas are relatively rare to encounter in clinical practice and infrequently associated with dental implant therapy. Methods. This study presents a case report of ranula formation in the right sublingual gland in association with dental implant therapy. In addition, a systematic review of case reports on this problem was conducted. The study aimed to identify the etiology of ranula development during/after implant therapy in patients undergoing implant-based dental rehabilitation. An advanced search was conducted on October 22, 2024, using the Web of Science, Scopus, and PubMed databases. The exported data demonstrated that reports on ranula formation were scarce. Four studies met the eligibility criteria; three were included in this analysis after quality assessments. Results. It was found that procedures leading to ranula formation were dental implant surgery in the mandible with perforation of the lingual plate and laceration of the sublingual or submandibular gland and placement of implant-retained overdentures causing duct obstructions. The treatment approaches included salivary gland excision (when the gland was traumatized) and duct marsupialization (when the ducts were obstructed). In the case report presented in this study, the etiology was attributed to soft tissue trauma caused by the implant drill during surgery. Different treatment modalities were used, including marsupialization, incision, and drainage. However, all led to a recurrence, and the gland was completely removed. Conclusions. Ranula formation has rarely been associated with dental implant therapy, with only a few reports in the literature. This case report suggests that ranulas may develop during implant placement, even if the lingual plate is not perforated. Such complications can be prevented through meticulous treatment planning and precise surgical techniques. The treatment of choice for ranulas remains sialadenectomy, especially in patients with a history of recurrence.