Anatomical Considerations on the Alveolar Antral Artery as Related to the Sinus Augmentation Surgical Procedure

Valente, Nicola Alberto

doi:10.1111/cid.12355

Cited by 24 publications

(36 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Thus, intrasinusal AAAs located between the sinus membrane and the bony wall makes critical the process of membrane detachment (9). This situation has been reported as the second most common (3,5) and accounts for 47.9% in our series. When the vessel follows a superficial course, external to the lateral wall of the sinus, the risk for haemorrhage would be higher when making the incisions, but not only during antrostomy (4).…”

Section: Discussionsupporting

confidence: 64%

“…Bleeding then results in longer operative times and favour additional complications such as perforation of the sinus membrane, or reduction of blood supply and displacement of the graft (2). Certain anatomic circumstances, like the diameter and position of the AAA together with the proximity to the alveolar crest may condition the appearance of this kind of complications (3,5). Arteries whose diameter is below 1mm are not a problem (15), but those larger than 2mm may represent a risk for bleeding (2).…”

Section: Discussionmentioning

confidence: 99%

“…Surgical planning based upon clinical records and CBCT explorations, and the use of piezoelectric devices for osteotomy permits a reduction of the surgical risk (5). Some authors have suggested ligating arteries >3 mm to prevent severe iatrogenesis (18,20,21).…”

Section: Discussionmentioning

confidence: 99%

“…Imaging Sciences International, 1910 North Penn Toad, Hatfield, USA) with its I-CAT software (Imaging Sciences International) set at a resolution of 0.3 voxels with 8.9 seconds of capture time. According to previous findings (4,5), the course of AAA lies closer to the bony crest at the upper first molar level, so this location was selected for performing the coronal sections used in this study.…”

Section: Methodsmentioning

confidence: 99%

“…In any case, the vascularity of the lateral sinus wall varies widely among individuals (2), being the risk for intrasurgical bleeding higher for larger vessels (>2mm) (2), in severely atrophic ridges, and at the area of the first upper molar where the distance between AAA and the alveolar crest is shorter (4,5). …”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Distance of the alveolar antral artery from the alveolar crest. Related factors and surgical considerations in sinus floor elevation

Pi¹,

Loira-Gago²,

González-Mosquera³

et al. 2016

Med Oral

View full text Add to dashboard Cite

BackgroundIn a variable proportion of maxillary sinuses alveolar antral artery is located close to the residual ridge, increasing the chances for haemorrhagic complications during sinus floor elevation procedures.Material and MethodsRetrospective observational study of CBCT explorations performed for implant-treatment planning. The upper first molar area was selected for this study. The relative uncertainty (standard deviation of the measurement divided by its mean and expressed as a percentage from 0% to 100%) was chosen for determining the observational errors. For modeling the chances of AAA detection, the generalized additive models (GAM) approach was chosen.ResultsA total of 240 maxillary sinuses were studied (46.25% males) whose median median age was 58 years old (IQR: 52-66). Univariate models showed that the chances for an AAA-alvelar crest distance ≤15mm increase in wider sinuses with lower, subsinusally edentulous crests. When distance is considered as a continuous variable, the best mutivariate model showed an explained deviance of 67% and included AAA diameter, distance AAA-sinus floor, sinus width, and shape, height and width of the residual ridge. Thinner AAAs are found closer to the crest (within the ≤15mm safe distance).ConclusionsBearing in mind the inclusion criteria and the limitations of this investigation, it is concluded that there is a high proportion of maxillary sinuses where AAA describes a course close to the alveolar crest (≤15mm), which was classically considered a safe distance for SFE. This position is related to the presence of atrophic crests (depressed ridge form) and wide maxillary sinuses where the distance of the vessel to the floor of the sinus is small. This information may permit a better surgical planning of SFE procedures. Key words:Cone-beam computed tomography, blood vessels, sinus floor augmentation, intraoperative complications.

show abstract

Section: Discussionsupporting

confidence: 64%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Distance of the alveolar antral artery from the alveolar crest. Related factors and surgical considerations in sinus floor elevation

Pi¹,

Loira-Gago²,

González-Mosquera³

et al. 2016

Med Oral

View full text Add to dashboard Cite

show abstract

Maxillary sinus augmentation via the bone lid technique: A prospective, radiographic case series

Rossana,

Chiara,

Marco

et al. 2024

Clin Adv Periodontics

View full text Add to dashboard Cite

BackgroundMaxillary sinus augmentation is one of the most performed procedures to increase the bone quantity of the atrophic maxilla to allow implant placement. The aim of the present case series was to describe a surgical protocol to perform maxillary sinus augmentation with the “bone lid technique,” and its outcomes in a cohort of patients eligible for the procedure.MethodsAfter the initial clinical evaluation, a cone‐beam computed tomography (CBCT) examination was performed for preoperative assessment. Patients were then scheduled for surgical intervention. At 6–9 months follow‐up, patients underwent a second CBCT scan to evaluate bone height following bone graft and to schedule implant placement.ResultsA total of 11 patients were enrolled in the study with a total of 13 sinus lift procedures. Membrane perforation was registered in 4 cases (30.76%). Mean surgical time was 67.69 min (SD 6.51). Postoperative period was uneventful in all patients, in the absence of complications. The mean graft volume increase was 2.46 cm3 (SD 0.85), and the mean height increase was 14.27 mm (SD 3.18). Mean membrane thickness was 1.40 mm (SD 0.75). In all the 4 cases with sinus membrane perforation, the membrane had a thickness lower than 1 mm.ConclusionsThe present study highlights that the maxillary sinus augmentation with bone lid repositioning could provide repeatable results in terms of bone height increase. The technique appears reliable both in terms of bone gain and absence of complications.Key points The bone lid technique for maxillary sinus augmentation provides repeatable results in terms of bone height increase. The favorable clinical outcomes can be related to an enhancement of bone formation due to the unique osteoconductive and osteoinductive properties of autogenous bone, along with a reduction of soft tissue ingrowth. Complications were not observed in any of the patients following the surgical procedures. The risk of Schneiderian membrane perforation is inversely proportional to membrane thickness; the thinner the membrane is, the higher the risk to perforate it.

show abstract

Evaluation of length and location of the maxillary sinus intraosseous artery using computerized tomography

Tran

Estrin

Saleh

et al. 2020

Journal of Periodontology

View full text Add to dashboard Cite

Background The intraosseous artery is a branch of the posterior superior alveolar artery that supplies the lateral wall of the maxillary sinus. The present study seeks to analyze the location of the intraosseous artery and its site of termination. Methods Cone beam computed tomography was used to evaluate 200 patients making up 400 maxillary sinuses. The following criteria were measured: (1) the distance of the lower border of the intraosseous artery to the floor of the sinus, (2) the average length of the artery, (3) the diameter of the artery, (4) the site at which the artery terminates at, and (5) the distance of the artery from the first premolar, second premolar, first molar, second molar, and third molar. Results The intraosseous artery was identified in 336 (84.0%) quadrants. The most common site of termination was at the mesial of the second molar (22%), regardless of dental status and right or left quadrant. Its overall mean diameter was 0.91 ± 0.56 mm, with no difference within the dental status. Its overall mean length was 7.40 ± 3.39 mm, with a statistically significant difference between dentate and edentulous quadrants (P < 0.001). Its overall mean distance from the floor was 6.95 ± 6.49 mm, with no difference within the dental status. All parameters showed no difference between right or left quadrants. Conclusions The chances of encountering the intraosseous artery at the premolar area is <21% during a lateral window sinus floor elevation. The most common (22%) site of termination of the intraosseous artery is at the mesial of the second molar. Understanding of the course, location, and termination of the artery enhances the precision of a clinician when it comes to pre‐operative treatment planning.

show abstract

Anatomical Considerations on the Alveolar Antral Artery as Related to the Sinus Augmentation Surgical Procedure

Abstract: Anatomical variants of the AAA that may increase the risk of severe intraoperatory bleeding are frequent and must be detected by the clinician implementing the use of the CBCT.

Cited by 24 publications

References 24 publications

Distance of the alveolar antral artery from the alveolar crest. Related factors and surgical considerations in sinus floor elevation

Distance of the alveolar antral artery from the alveolar crest. Related factors and surgical considerations in sinus floor elevation

Maxillary sinus augmentation via the bone lid technique: A prospective, radiographic case series

Evaluation of length and location of the maxillary sinus intraosseous artery using computerized tomography

Contact Info

Product

Resources

About