Abstract
Purpose: To assess the location of posterior superior alveolar artery (PSAA) using CBCT in relevance to sinus lift procedure for implant placement. Patients and Methods: A retrospective study was conducted using the CBCT data of 500 patients (n = 500). Linear measurements were carried out to localize the medio-lateral and vertical position of posterior superior alveolar artery in postero-lateral wall of maxillary sinus and its proximity to the floor of maxillary sinus using CS 3D imaging 3.7.0 software program. The relative position of PSAA was determined as; (a) intra-osseous, (b) below the membrane and (c) outer-cortex of lateral sinus wall. The location of PSAA was assessed in molar region bilaterally by using following radiographic measurement; (1) distance between the lower border of posterior superior alveolar artery and alveolar crest, (2) height from the floor of maxillary sinus to alveolar crest and (3) distance from the posterior superior alveolar artery to medial wall of maxillary sinus. Results: The prevalence of the artery was observed in 99.4% of the sinuses and was mostly intraosseous (84.2%).The mean distance between the lower border of the artery and alveolar crest is significantly higher in males compared to females (P < 0.01). The distribution of artery location did not differ significantly across various age groups (P > 0.05). Discussion/Conclusion: The most common variant of PSAA was identified in the intra-osseous region and the mean distance of the vessel to crest of the residual ridge differs significantly with gender and not with age.
Highlights
The treatment protocol for prosthetic rehabilitation in the posterior maxilla is often complicated as bone resorption commonly precedes or accompanies tooth loss
The location of PSAA was assessed in molar region by using following measurements: – Distance between the lower border of posterior superior alveolar artery and alveolar crest (Fig. 4)
The prevalence of PSAA reported in this study was 99.4%, observed in the following positions: – intra-osseous 84.2%
Summary
The treatment protocol for prosthetic rehabilitation in the posterior maxilla is often complicated as bone resorption commonly precedes or accompanies tooth loss. Deficient posterior alveolar ridge along with increased pneumatisation of the maxillary sinus makes it a surgically challenging zone for implant supported prosthesis [1,2]. The maxillary sinus is bordered superiorly by floor of the orbit, medially by the nasal cavity, anteriorly by infratemporal surface of the maxilla and inferiorly by alveolar and palatine processes of the maxilla [3]. The mean distance between the maxillary posterior teeth and the floor of the sinus is about 1.97 mm [5]. The antral anatomy is intricate since primary as well as secondary septa may be present in the maxillary sinus, their location may vary.
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