Diameter of alveolar antral artery in the lateral sinus wall: study of related factors

Varela‐Centelles, Pablo; Seoane, Juan; Loira-Gago, M.; González-Mosquera, Antonio; Seoane-Romero, Juan M.

doi:10.1016/j.bjoms.2016.12.001

Cited by 8 publications

(6 citation statements)

References 6 publications

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“…The independence of these variables suggests that no correlations can be established between the specific types of PSAA and patient gender, artery diameter, or residual alveolar ridge characteristics. These findings are in line with those of similar studies [ 30 , 36 ]. At the same time, the enormous variation in PSAA data, together with the fact that other authors do not always agree with our data (Table 4 ), highlight the importance of correct diagnosis in terms of the artery’s position and features.…”

Section: Discussionsupporting

confidence: 94%

“…Knowing the exact size (diameter) of the PSSA will be clinically helpful, given that various authors have reported that arteries with a diameter of over 1 mm increase the risk of bleeding by up to 57%, a value which is even higher when the diameter exceeds 2 mm [ 21 , 27 – 29 ]. Our results are consistent with those of other authors who found arteries in excess of 1 mm in diameter in over half of cases assessed using CBCT in patient samples similar to the present work [ 24 , 30 , 31 ]. Knowing the precise height of the artery above the alveolar ridge is also clinically relevant as this dictates the limits of the sinus access window.…”

Section: Discussionsupporting

confidence: 94%

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Anatomical variations and accessory structures in the maxilla in relation to implantological procedures: an observational retrospective study of 212 cases using cone-bean computed tomography

et al. 2022

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Purpose This study used cone-beam computed tomography (CBCT) to analyze the prevalence of several maxillary anatomical/accessory structures, as well as variations within each type, assessing how accurate diagnosis can minimize the risk of intraoperative complications during implantological procedures in the oral cavity. Methods 212 CBCT scans of the maxilla were analyzed, captured over a period of 18 months for surgical planning purposes. The prevalence of posterior superior alveolar arteries (PSAA), maxillary sinus septa (MSS), and branches of the canalis sinuosus (CS) were evaluated, as were the diameter and location of each anatomical structure in horizontal and vertical planes. P < 0.05 was considered statistically significant. Results PSAAs were observed in 99.1% of cases, the intrasinus type being the most frequent; MSS were noted in 15.6% of the sample, mainly in the posterior region with sagittal orientation; CS branches were observed in 50% of patients, mainly in relation to the incisors and significantly more prevalent among males. Conclusions The use of CBCT significantly increases the possibility of clearly identifying these anatomical structures. The differences found between patients highlight the importance of carrying out an exhaustive radiological study of the individual to prevent complications, such as Schneiderian membrane perforation, neurovascular damage or bleeding during surgery. Graphical Abstract

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Section: Discussionsupporting

confidence: 94%

Section: Discussionsupporting

confidence: 94%

Anatomical variations and accessory structures in the maxilla in relation to implantological procedures: an observational retrospective study of 212 cases using cone-bean computed tomography

et al. 2022

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“…The further the AAA is from the crest, the larger its diameter [25]. While some authors have dictated that vessels > 15 mm from the crest can be safe as this 4).…”

Section: Anatomymentioning

confidence: 99%

A Simple Method of Managing the Alveolar Antral Artery during Sinus Lift Surgery

Yang¹,

Lee²

2021

IJOHNS

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The alveolar antral artery resides lateral to the maxillary sinus and can lead to complications in sinus lift surgery. Traditional approaches that decrease intraoperative bleeding into the surgical field include vessel preservation using multiple bony windows or neutralizing the vessel at the surgical site. Unfortunately, these methods are technique sensitive, time intensive, and may lead to hemosinus and graft loss. The variable distance from the crest of the alveolar ridge and vessel diameter further complicates pre-operative planning. This paper discusses the anatomical features of the alveolar antral artery, techniques for clinical assessment, and current management strategies. We then describe a novel protocol to manage the alveolar antral artery in sinus lift procedures via tamponade of the vessel at a proximal site. This method is faster than those described in the literature, does not require any additional equipment or expertise, and aims to improve long-term graft predictability by decreasing the risk of sinus membrane perforation. The alveolar antral artery is an under-reported source of surgical complications and warrants further research.

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“…On the other hand, gender resulted to be an explanatory variable in the multivariate model influencing artery detection. Larger diameters and higher detection rates were found amongst males 15,18,19 , which implies higher chances for intra-operative bleeding for this group [15][16][17][18][19][20] . The thickness of the sinus lateral bony wall also behaved as an explanatory variable, as larger AAAs were identified in thicker walls 2,19 .…”

Section: Discussionmentioning

confidence: 86%

“…Recent reports have described the location of AAA in terms of height of the alveolar crest and the diameter of the AAA 16,17 , but produced no predictive models explaining the detection of the AAA in the lateral wall of the maxillary sinus.…”

mentioning

confidence: 99%

Study of factors influencing preoperative detection of alveolar antral artery by CBCT in sinus floor elevation

Varela‐Centelles

Loira

González-Mosquera

et al. 2020

Sci Rep

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This study aimed at assessing the prevalence of alveolar antral artery (AAA) detection by CBCT, its related variables, and at describing explanatory models useful in surgical planning, by retrospective evaluation of CBCT explorations. The modelling of the probability for detecting AAA was undertaken using logistic generalized additive models (GAM). The capacity for discriminating detection/no detection was assessed by receiver operating characteristic curves. A total of 466 sinuses were studied. Univariate models showed detection probability was linked to sinus width and thickness of the lateral bony wall, together with the shape and height of the osseous crest. AAA detection probability increased steadily until the thickness of the bony wall reached 6 mm. Multivariate models resulted good discriminators for AAA detection, particularly for females, showing an area under the curve (AUC) of 0.85. Models considering patients altogether, and those including only males offered slightly lower values (AUC = 0.79). The probability of AAA detection by CBCT was influenced by gender (higher in males and for narrow sinuses) and increases with the thickness of the sinus lateral bony wall and the height of the residual alveolar ridge. Besides, and particularly for women, the thickness of the ridge at the basal level seems to improve the explanatory model for AAA detection. Maxillary sinus floor elevation (SFE) by lateral approach is a safe and predictable procedure for augmenting bone tissue volume for implant placement 1 , but certain potential complications have to be taken into account intraoperatively (Schneider's membrane perforation, haemorrhage from the alveolar antral artery (AAA), osteomeatal complex obstruction) and post-operatively (sinus congestion, graft mobility, acute sinusitis, and cyst formation) 2. Accidental bleeding secondary to surgical damage of AAA is the second most frequent complication of SFE 2,3. In fact, up to 20% of major bleeding events are due to accidental AA impairment 4,5. These events may result in suspension of the surgery, a slower surgical procedure, reduction of blood supply, mobilisation of the graft, as well as in an increase in the risk for membrane perforations 2. The AAA is an anastomosis of the posterior superior alveolar artery (PSAA) and the infraorbital artery (IOA) which has been repeatedly identified by dissection in 100% of the lateral sinus walls of cadavers 6-10. The vessel can follow either a straight or a U-shaped course in the anterolateral wall of the sinus, reaching its closest point to the alveolar crest at the site of the first or second molar 11,12. The AAA also maintains a varying relationship with the sinus wall, being usually completely intraosseous and rarely (< 8%) more superficial (under the periosteum) on the lateral wall 3,12. These circumstances make AAA identification during surgical planning particularly important for avoiding undesired complications 13. Although cone beam computed tomography (CBCT) has proved better than conventional computed tomography (...

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Diameter of alveolar antral artery in the lateral sinus wall: study of related factors

Cited by 8 publications

References 6 publications

Anatomical variations and accessory structures in the maxilla in relation to implantological procedures: an observational retrospective study of 212 cases using cone-bean computed tomography

Anatomical variations and accessory structures in the maxilla in relation to implantological procedures: an observational retrospective study of 212 cases using cone-bean computed tomography

A Simple Method of Managing the Alveolar Antral Artery during Sinus Lift Surgery

Study of factors influencing preoperative detection of alveolar antral artery by CBCT in sinus floor elevation

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