Cone Beam Computed Tomography Analysis of Posterior-Superior Alveolar Canal from a Fixed Reference Point: Implications for Sinus Floor Elevation Procedure through Lateral Approach.

Abstract

Sinus floor elevation is commonly done in the maxillary posterior region prior to dental implant placement. This study primarily aimed at assessing the location of the posterior superior alveolar artery (PSAA) canal on cone beam computed tomography (CBCT) scans and its relation to the alveolar ridge and maxillary sinus from a fixed reference point. A total of 226 edentulous maxillary molar sites were included in this retrospective analysis. The distance from the PSAA to the sinus floor (SF), alveolar crest (AC) and a fixed reference point, that is, the roof of sinus (RS) were measured. The alveolar bone height (ABH), thickness of the crestal keratinized mucosa (CKM) and thickness of Schneiderian membrane (SM) were also evaluated. 54 sites (23.89%) were excluded from the study. The SF, AC, RS and ABH values averaged at 11.91mm ± 3.63mm, 16.05mm ± 3.96mm, 25.32mm ± 7.13mm and 4.93mm ± 4.27mm respectively. SF and AC was higher in second molar than first molar region (p < 0.001), but RS did not show significant difference (p = 0.85). CKM and SM averaged at 2.02mm ± 0.68mm and 1.31mm ± 0.81mm respectively. The PSAA can be visualized in CBCT scans with a prevalence of 76.11% and may not be detected when adherent to the sinus membrane. This study stresses on the need for a CBCT, prior to sinus surgeries through lateral approach, to assess the PSAA.