Evaluation of the Posterior Superior Alveolar Artery Using Cone Beam Computed Tomography

Abstract

SummaryBackgroundMaxillary posterior tooth region is an important area with respect to periapical surgery, implant placement, and sinus lifts. Posterior superior alveolar artery (PSAA) is located on the lateral wall of maxillary sinus and may become injured during such surgical procedures. Therefore, knowledge of the subject is essential to a clinician.The goal was to determine the anatomical relationship of posterior superior alveolar artery to the floor of maxillary sinus and alveolar crest.In our study we attempted to present the locations and course of posterior superior alveolar artery (PSAA) using cone beam computed tomography (CBCT) imaging.Material/MethodsCBCT scans of 50 patients (30 males, 20 females) who had undergone computed tomography imaging were analyzed. We assessed the visibility and location of vascular canal/notch of posterior superior alveolar artery on cross sectional images and measured the distances from lower margin to the floor of maxillary sinus and alveolar crest in the 1st molar and 2nd molar regions. Unpaired t-test was carried out in the analysis to determine the level of significance.ResultsMaxillary PSAA was visualized in 36 patients (70%). Mean diameter of the vessel was 0.63 mm. Mean distance between PSAA and alveolar crest was the shortest in the 2nd molar region. The mean distance between PSAA and floor of maxillary sinus was 9.96 mm.ConclusionsPeriapical surgeries, implants and maxillary sinus lift are performed on routine basis. PSAA is an important structure in the posterior maxillary region; the clinician should be aware of its location and course. CBCT is an excellent tool to localize the PSAA because of it provides finer details at low exposure and less radiation. It should be recommended in clinical practices.

The radiological evaluation of posterior superior alveolar artery topography by using computed tomography

“…The diameter of PSAA was measured between 0.63 ± 0.38 and 1.24 ± 0.18 mm in the literature. 22,23 In accordance with the literature, the PSAA diameter in first premolar, second premolar, first molar, and second molar regions were measured 0.97, 0.88, 0.9, and 0.94 mm, respectively. Almost in all studies, the most frequent PSAA localization was classified as intraosseous.…”

Evaluation of the Posterior Superior Alveolar Artery Prior to Sinus Floor Elevation via Lateral Window Technique: A Cone-Beam Computed Tomography Study

“…The reason as to why CBCT results are higher than the CT results may be due to the higher resolution of CBCT, the specialization and/or experience of the examiners, the methodology applied, and whether dentulous or edentulous patients are included in the study as well as sample size. 25,28,29…”

“…Güncü et al 24 detected that this distance was 7.8 ± 0.3 mm. Pandharbale et al 28 stated that the distance between the PSAA canal/notch and the floor of the maxillary sinus in the left first and second molar regions was 10.48 ± 3.21 mm and 9.49 ± 3.12, respectively, and was shortest in the second molar region. In this study, the mean distance from the PSAA to the floor of the sinus was 9.54 ± 4.27 mm at the FDP and 7.91 ± 4.75 mm at the LDP.…”

Clinical anatomy of the maxillary sinus: application to sinus floor augmentation

“…CBCT studies showed that PSAA was detected in 61 to 87% of the patients; it was located underneath the mucosa in 22% to 47% (type I), intraosseus in 47% to 73% (type II) and external cortex (superficial) in 5% to 6% (type III), and the mean diameter of the PSAA was 0.63 mm to 1.37 mm [29303132]. According to Khojastehpour et al [33], the rate of the detection rate of the PSAA in patients with an alveolar ridge height of <10 mm was significantly greater than the rate of detection in patients with an alveolar ridge height of >10 mm.…”