Determining the location of the internal maxillary artery on ultrasonography and unenhanced magnetic resonance imaging before orthognathic surgery

Ultrasonographic assessment of the maxillary artery and middle meningeal artery in the infratemporal fossa

“…The MXA is one of the main arteries supplying the facial region, and evaluating its blood flow has numerous potential implications in cranio‐maxillo‐facial surgery and otorhinolaryngology, in the evaluation of the blood supply to tumors and vascular malformations, as well as in epistaxis treatment . Changes in the Doppler waveforms, with lower RI and PI, may be expected if the MXA is involved in collateral networks in patients with occlusive carotid disease, or in patients with extracranial‐intracranial by‐pass using the MXA for the treatment of complex cerebrovascular disorders and skull base tumors .…”

“…On the other hand, there are no studies reporting visualizing the MMA or assessing its blood flow. Ultrasonographic visualization of the MXA and its MMA branch in ITF may allow their assessment in headache and migraine, intracranial hematomas, and extracranial‐intracranial by‐pass surgery, as well as to assess collateral flow development in carotid occlusive diseases and the vascularization of tumors and vascular malformations of the facial region …”

“…Ultrasonographic visualization of the MXA and its MMA branch in ITF may allow their assessment in headache and migraine, intracranial hematomas, and extracranial-intracranial by-pass surgery, as well as to assess collateral flow development in carotid occlusive diseases and the vascularization of tumors and vascular malformations of the facial region. 2,[6][7][8][9][10] The aim of this study was to develop and present a method to visualize the MMA and MXA in the ITF, correctly identify these two arteries based on their anatomy and blood-flow features, and describe their hemodynamic characteristics in a group of subjects without vascular disease. After the visualization of the arteries, we measured the depth of insonation (DI), and obtained the pulsed Doppler signal of the MXA and the MMA, on which we measured the angle corrected peak We anticipated that the Doppler spectrum characteristics of MXA and MMA would be intermediate between those of extra and intracranial arteries 12,13 (Figure 3).…”

Use of cone beam computed tomography in implant dentistry: current concepts, indications and limitations for clinical practice and research

“…Cone beam computed tomography examinations must not be carried out without a medical history and clinical examination 2 Cone beam computed tomography examinations must be justified for each patient to demonstrate that the benefits outweigh the risks 3 Cone beam computed tomography examinations should potentially add new information to aid the patient's management 4 Cone beam computed tomography should not be repeated 'routinely' on a patient without a new risk/benefit assessment 5 When accepting referrals from other dentists for cone beam computed tomography examinations, the referring dentist must supply sufficient clinical information to justify the examination 6 Cone beam computed tomography should only be used when the question for which imaging is required cannot be answered adequately by lower-dose conventional radiography 7 Cone beam computed tomography images must undergo a thorough clinical evaluation of the entire image data set (reporting) 8 When soft-tissue evaluation is required, the appropriate imaging should be conventional medical computed tomography or magnetic resonance, rather than cone beam computed tomography 9 Cone beam computed tomography equipment should offer a choice of volume sizes, and examinations must use the smallest that is compatible with the clinical situation 10 Where cone beam computed tomography equipment offers a choice of resolution, the resolution compatible with adequate diagnosis and the lowest achievable dose should be used 11 A quality assurance program must be established and implemented for each cone beam computed tomography facility, including equipment, techniques and quality control procedures 12 Aids to accurate positioning (light beam markers) must always be used 13 All new installations of cone beam computed tomography equipment should undergo an examination and detailed acceptance tests before use to ensure that radiation protection for staff, members of the public and patient are optimal 14 Cone beam computed tomography equipment should undergo regular routine tests to ensure that radiation protection has not significantly deteriorated 15 For protection of staff from cone beam computed tomography equipment, the guidelines detailed in Section 6 of the European Commission document Radiation Protection 136. European guidelines on radiation protection in dental radiology should be followed 16 All those involved with cone beam computed tomography must have received adequate theoretical and practical training for the purpose of radiological practices and competence in radiation protection 17 Continuing education and training after qualification are required, particularly when new cone beam computed tomography equipment or techniques are adopted 18 Dentists responsible for cone beam computed tomography facilities who have not previously received 'adequate theoretical and practical training' should undergo a period of additional theoretical and practical training that has been validated by an academic institution (university or equiva...…”

“…When cross‐sectional imaging is indicated, cone beam computed tomography has been recommended over to be preferable over computed tomography ; however, imaging modalities with the ability to perform visualization of craniofacial hard and soft tissues without radiation exposure would be desirable. Currently, there are two modalities that show some clinical potential in this regard: magnetic resonance imaging; and ultrasound . Magnetic resonance imaging as a nonionizing diagnostic tool in the dento‐maxillofacial region has been limited mostly because of compromised visualization of hard tissues and feasibility concerns such as availibility of equipment and high costs .…”