Evaluation of the posterior superior alveolar artery and the maxillary sinus with CBCT

Abstract

Evaluation of the posterior superior alveolar artery and the maxillary sinus with CBCT Abstract: Assessment of the maxillary sinus anatomy before sinus augmentation is important for avoiding surgical complications, because of the close anatomical relationship between the posterior maxillary teeth and the maxillary sinus. The posterior superior alveolar artery (PSAA) is the branch of the maxillary artery that supplies the lateral sinus wall and overlying membrane. We evaluated the location of the PSAA and its relationship to the alveolar ridge and maxillary sinus using cone beam computed tomography (CBCT). The study group consisted of 135 CBCT scans (270 sinuses) obtained from the archive of the dentomaxillofacial radiology department at Yeditepe University Faculty of Dentistry, Istanbul, Turkey. The distance between the lower border of the artery and the alveolar crest, bone height from the sinus floor to the ridge crest, distance from the artery to the medial sinus wall, and the diameter and location of the artery were determined. The occurrence of septa and pathology were recorded from CBCT scans. The PSAA was observed in 89.3% of sinuses, and 71.1% of arteries were intraosseous with diameters mostly ≤ 1 mm (68.9%). The prevalence of sinus septa was 55.2%, and that of sinus pathology was 57.4%. The mean age was 43.07 ± 17.55 years. There was a statistically significant difference between the location of the artery and gender (p < 0.05). The prevalence of sinus membrane thickening was 57.4%. Detailed knowledge about the location of the PSAA and sinus morphology may be obtained with CBCT before maxillary sinus surgery.

Prevalence, Location, and Size of Maxillary Sinus Septa: Computed Tomography Scan Analysis

“…The prevalence rates of septa have been reported differently in different studies, depending on the type of edentulism (partial or complete), the patients being dentate, and the imaging technique used (CBCT, CT, or panoramic). Ilguly et al, 33 Maestre-Ferrín et al, 7 Malec et al, 23 Qian et al, 24 and Sakhdari et al 25 reported rates of 55.2, 53.2, 49, 48.2 and 44.8% respectively, for the prevalence of sinus septa, almost consistent with the results of the present study. Based on a study by Faramarzie et al, 26 the sequence of tooth extraction might affect the position of septa in the maxillary sinus.…”

Cone beam computed tomography investigation of the antral artery anastomosis in a population of Central Italy

“…In 2007 Mardinger et al [13], using the CT scan method, was able to detect the anastomosis in 50% of the considered sample. Ilgüy et al [11] in 2013, using the CBCT, had more rate of success in finding the anastomosis. Indeed the CBCT provides accurate and reliable linear measurement for imaging of dental and maxillofacial surgery.…”

“…In both of arches, it means that the restorative treatment by implants depends on the quantity and quality of residual bone, because of the presence of two noble anatomical structures: alveolar canal in the inferior jaw and the maxillary sinus in the upper jaw. The principal surgical technique to gain a height augmentation is the sinus floor lift procedure, with a lateral approach [4][5][6][7][8][9][10][11][12]. In this procedure, the knowledge of the vascular supply of this region is mandatory, to avoid unwanted haemorrhagic complications and to guarantee a good vascularisation of the grafted material [2,3,5].…”

“…In this study, the dentate and edentulous data were not distinguished, because the sample of found anastomosis was too small. We chose the apex as reference point because the centre of the crown, as chosen by Ilgüy et al [11], or the cement enamel line were too distant, if compared with the ones found in the edentulous patients. However, the data reported in this study stay in the range of the ones found in literature.…”

“…Rosano et al [14,15] in 2009-2010 in cadaveric study confirmed the data reported by Solar et al [18] and Traxler et al [18] in 1999. Ilgüy et al [11] in 2013 reported measures, septa presence and that the undetection of the anastomosis on cone beam CT (CBCT) is probably caused by the small diameter. The more recent study was by Rysz et al [16] in 2014, which focused this time on adult CBCT scans.…”