Mandibular Arteriovenous Malformation: Case Report

ABSTRACT Background: Arteriovenous malformations (AVMs) of the mandible are rare vascular anomalies that can lead to life-threatening hemorrhage during routine dental procedures. The purpose of this case report is to highlight the importance of early recognition, radiographic assessment and multidisciplinary management of mandibular AVMs. Methods: A 13-year-old male patient with a medical history of epilepsy well-controlled with levetiracetam, presented with intraoral soft tissue swelling and spontaneous gingival bleeding localized to the right mandibular molar region. Diagnostic work-up included panoramic radiography, cone-beam computed tomography (CBCT) and contrast-enhanced computed tomography (CT). Hematologic evaluation, including coagulation factor analysis was performed to exclude systemic bleeding disorders. Results: Imaging revealed a radiolucent lesion with marked cortical thinning and increased vascularity. Following extraction of the mandibular first molar the patient experienced severe postoperative bleeding. Hemostasis was achieved through local compression, topical tranexamic acid application and electrocauterization although bleeding control was challenging. The patient was followed up for 12 months during which serial panoramic radiographs demonstrated satisfactory bone healing without recurrence of bleeding. Conclusions: This case underscores the clinical significance of thorough radiographic assessment and early identification of mandibular AVMs. Timely and meticulous management is essential to prevent potentially fatal hemorrhagic complications in dental practice.