The Radiological Evaluation of Posterior Superior Alveolar Artery by Using CBCT

Abstract

Background: Evaluation of the maxillary sinus anatomy prior to sinus lift procedures is important to avoid surgical complications due to the close anatomical relationship between the posterior maxillary region and the maxillary sinüs. Introduction: In order to avoid traumatizing the posterior superior alveolar artery and to prevent perioperative bleeding, locating exact position of the artery is imperative before the surgical procedures. Methods: 150 CBCT scans were evaluated. The distance from the inferior border of the PSAA to the alveolar crest (the vertical line from the artery to the crest) and floor of maxillary sinus, the distance from PSAA to medial sinus wall, nasal septum, zygomatic arch, position, distance from floor of maksiller sinüs to the alveolar crest and diameter of the PSAA were assessed. Locations of the artery were classified. Results: The artery diameters were mostly ≥ 1 mm. Artery was mostly intraosseous (59.7%), 21.7 % was superficial and only 18.7% was intra-sinuscular. Conclusion: The location of PSAA is intraosseous in most patients. The artery diameters were mostly ≥ 1 mm and we can say that increasing the size also increases the risk of complications.

The prevalence and location of the posterior superior alveolar artery in the maxillary sinus wall: A preliminary computed-cone beam study

“…This result falls within the range reported by Laovoravit et al (2021) . These results are higher than those of previous studies ( Pandharbale et al, 2016 , Karslioglu et al, 2020 , Hur et al, 2009 , Jung et al, 2011 , Park et al, 2012 , Kang et al, 2013 , Apostolakis and Bissoon, 2014 , Watanabe et al, 2014 , Yang and Kye, 2014 , Bedeloğlu and Yalçın, 2020 , Fayek et al, 2021 ). The difference may be attributed to the use of the lower point of the maxillary sinus and the lower border of PSAA as landmarks.…”

“… Pandharbale et al, 2016 , Yang and Kye, 2014 , and Tran et al (2021) reported no statistical differences in the measurements between male and female populations, a finding that we concur with. In contrast, Laovoravit et al, 2021 , Karslioglu et al, 2020 reported that the distance from the artery to the floor of the maxillary sinus was greater in males compared to females. They attributed this to the anatomic variation in the artery position.…”

“…Moreover, given the difference in texture and density between the alveolar ridge and maxillary sinus wall, most surgeons would be able to visualize the sinus with its transparent nature. There are at least 13 studies that also measured the distance between the sinus floor and the PSAA ( Hur et al, 2009 , Jung et al, 2011 , Park et al, 2012 , Kang et al, 2013 , Apostolakis and Bissoon, 2014 , Watanabe et al, 2014 , Yang and Kye, 2014 , Kawakami et al, 2019 , Bedeloğlu and Yalçın, 2020 , Karslioglu et al, 2020 , Fayek et al, 2021 , Laovoravit et al, 2021 ).…”

Anatomic evaluation of the posterior superior alveolar artery using cone-beam computed tomography: A systematic review and meta-analysis

“…In the review, 6 characteristics of the PSAA were investigated. A total of 34 1 9 10 12 13 14 15 16 17 18 20 21 23 24 25 26 27 28 29 30 31 32 33 34 35 41 61 62 63 64 65 66 67 68 studies examined the detection of the artery, 27 studies analyzed its diameter, 1 12 13 14 15 16 18 19 20 21 23 24 26 28 31 32 33 35 41 61 62 63 65 66 67 68 69 25 studies investigated its location, 1 10 12 13 14 15 16 17 20 21 25 26 27 29 31 32 33 34 41 62 <...…”

“…10 12 13 14 15 17 18 19 20 21 23 24 25 28 30 31 32 33 35 41 62 63 64 65 66 67 68 69 The number of sinuses examined in these studies ranged from 83 to 788 ( Table 1 ). In terms of quality assessment score, 13 studies were classified as high-quality, 9 15 19 23 24 28 29 31 61 62 65 66 69 22 as moderate-quality, 1 10 12 14 16 17 18 21 25 26 27 30 32 33 34 35 41 63 64 67 68 70 and 2 as low-quality. 13 20 The results of this quality assessment are presented in Table 2 .…”