Evaluation on the position of the posterior superior alveolar artery in relation of the maxillary sinus with CBCT

Abstract

All the surgical operations and placement of dental implants in the posterior maxillary region require detailed knowledge of maxillary sinus anatomy and possible anatomical variations. The blood supply of the maxillary sinus is derived from following branches of the maxillary artery: the posterior superior alveolar artery and the infraorbital artery. The aim of the present investigation was to determine diameter of the artery, location and position the posterior superior alveolar artery (PSAA) in relation to alveolar ridge and medial wall of sinus, prevalence pathology and septa from using cone beam computed tomography (CBCT).Material and Methods: The number of 200 CBCT (400 sinus) related to patients above twenty years old were assessed. Lower border of the artery to the alveolar crest, distance of the artery to the medial sinus wall, diameter of the artery, and position of the artery were measured; presence of septa and pathology in four groups: a- Edentulous men in posterior area b- Dentulous men in posterior area c- Edentulous women in posterior area d- Dentulous women in posterior area were recorded from CBCT sections.Result: Mean lower border of the artery to the alveolar crest without divided to groups 16.17±1.63 and difference that was statistically significant (p < 0.05). Mean distance of the artery to the medial sinus wall was 11.56±1.21 and difference that was not statistically significant (P=.796). Mean diameter of PSAA was found 1.137±.44 mm and was not statistically significant between the diameter of the artery in four groups (P=.570). When diameter of PSAA divided into categories based on Percent to three groups: a- Less than 1 mm 30.2%, b- Between 1 to 2 mm 59.1, More than 2mm 10.5% was recorded. The position of the artery was in 73.2% of all sinuses intraosseous, 21.7% was below the Schneiderian membrane and only 4.9% was detected on the outer cortex of the lateral sinus wall. Prevalence of sinus septa and sinus pathology was 45.7% and 26%, respectively.Conclusion: Position and distance of the posterior superior alveolar artery to the ridge crest should be evaluated before surgery. However, CBCT is useful for evaluation of potential variation of the sinus and presence of septa and pathology