The sublingual and submental arteries normally anastomose through their muscular mylohyoid branches. Loukas et al. only identified anastomotic patterns between sublingual and submental arteries in 40 % of the dissected cadavers, with no case where the two terminate as a single sublingual artery. We found three (8.9 %) cases of an anastomotic branch of the submental and lingual artery forming a single sublingual artery just before entering the MMLF.

The distance from the MMLF to the inferior border of the mandible in our study ranged from 11.03 to 19.62 mm (mean = 15.58 mm ± 2.12 SD) with no statistically significant difference between the two genders (U = 46.000, P = 0.454). Oettle et al. reported a distance ranging from 10.83 to 12.874 mm in a dry mandible study of both black and white South Africans. In their study, cone beam computed tomography (CBCT) was used to scan the mandibles. Their study did not find a statistically significant difference according to sex or race. Soft tissue remnants on the surface of the mandibles in our study could explain the higher morphometric measurements.

A critical buccal bone thickness of 2 mm is recommended to prevent vertical resorption. A minimum bone thickness of 6 mm would be required for successful placement of a standard-sized ±4-mm-diameter implant. In the current study, the bucco-lingual thickness of the mandible at the level of the MMLF ranged from 8.00 to 12.91 mm (mean = 10.89 mm ± 1.24 SD). Thus, all the cadavers in our study had adequate bone thickness needed for implant placement without perforating the lingual cortical plate and traumatizing the sublingual artery.

A notable limitation in our study was a lower number of female cadavers available. Most of these cadavers are unclaimed bodies from mortuaries in Kenya. Generally, there are more male unclaimed bodies than female bodies. The Mann-Whitney U test was therefore used to compare the two genders.

Within the limitations of this study, the sublingual artery that enters the MMLF was found to be the sublingual artery as either a branch of the lingual artery (73.5 %), the submental artery (17.6 %) or an anastomosis of the lingual and submental arteries (8.9 %). We suggest that extra-oral ligation of the lingual artery should be done first followed by ligation of the submental artery (or its parent facial artery) in case of continued bleeding. Studies with a larger sample of females should be conducted to confirm the findings of this study.