Posterior Superior Alveolar Artery Research Articles

Anatomical study on the posterior alveolar canal in maxillary tuberosity region using computed tomography

ObjectiveThis study aimed to identify the anatomical characteristics of the posterior alveolar canal (PAC) and related maxillary bone using computed tomography (CT). MethodsThe study included 40 Japanese cadavers (70 hemi-heads), comprising 23 males (41 hemi-heads) and 17 females (29 hemi-heads). Simple CT data of the maxillary bone region of the specimens were obtained and analyzed using a measurement software with reference to the Frankfurt horizontal (FH) plane to identify the PAC in the maxillary tuberosity region, alveolar crest (AC), and corner of the inferior crest of the zygomatic process (CICZP). The shortest distances between the PAC and the respective landmarks and the smallest width of the posterior wall of the maxillary sinus (WPWMS) at the PAC level were calculated and analyzed statistically. ResultsOf all specimens, the mean and SD of AC-PAC: 21.4 ± 3.32 mm, horizontal PAC-CICZP: 15.1 ± 2.89 mm, vertical PAC-CICZP: 5.70 ± 3.15 mm, WPWMS: 0.81 ± 0.31 mm, and the coefficients of variation ranged 15.5–55.3%. In the WPWMS, the mean value was statistically smaller in the female group (0.59 mm) than in the male group (0.96 mm) (p < 0.001). ConclusionsThe results showed certain tendencies in the distances between the PAC and the respective anatomical landmarks with large variations. The thickness of the posterior wall of the maxillary sinus was thinner in females than in males. However, it is < 1 mm in both sexes, and external forces caused by trauma or surgery may fracture the posterior wall of the maxillary sinus and damage the posterior superior alveolar artery regardless of sex.

Utilizing a Novel AI Tool to Detect the Posterior Superior Alveolar Artery's Location's Impact on Maxillary Sinus Mucosal Thickening in the Presence of Periapical Lesions.

Periapical lesions have been implicated in sinus-related complications, but the precise influence of anatomical variations in the posterior superior alveolar artery (PSAA) on mucosal thickening remains an uncharted aspect. The new AI tool employed in this research utilizes advanced image processing algorithms to enhance image visualization. Background and Objectives: This study examines the accuracy of a new cone beam computed tomography (CBCT) software (eVol DXS, version 1.0.1.0) employing AI to detect the PSAA's location and the effect of that on maxillary sinus thickening in the presence of periapical lesions. Materials and Methods: This retrospective study included 120 CBCT cases with posterior maxillary periapical lesions and 120 without odontogenic infections. Teeth with proximity (<2 mm) to the sinus were excluded in both groups to eliminate the sinus floor's perforation effect. Both the PSAA locations and maxillary sinus thickening were classified and compared. Results: The mucosal thickening differs significantly (p < 0.001) between the study group and the control group. The study showed that an increased sinus thickness occurred when the PSAA was beneath the sinus membrane in the study group (62.5% compared to 8.6%; p < 0.001 *). The AI tool helped to achieve a 100% identification rate in determining the PSAA locations. Conclusions: AI algorithms for PSAA localization, which affects mucosal thickness in response to periapical lesions, yield excellent results.

Assessment of neurovascular channels in lateral maxillary sinus wall using cone-beam computed tomography: An imperative clinicians guide for implant placements.

The aim of this study is to evaluate the location and radio morphometric features of the posterior superior alveolar artery (PSAA) in patients undergoing rehabilitation of posterior maxilla and other sinus augmentation surgical procedures by cone-beam computed tomography (CBCT). A total of 816 CBCT scans were included. Various radio morphometric measurements were done to assess the PSAA location, diameter, and distances to the sinus floor and alveolar crest. The PSAA was mostly intraosseous in the maximum in the age group 31-51 years (56%), in males (53.4%), and in dentate patients (57.4%). The artery tends to be wider in older patients. Distances to the sinus floor or the alveolar crest tend to be shorter in women. This study suggests that CBCT is a valuable pre-surgical tool and the evaluation of the PSAA on CBCT images could reduce the likelihood of excess bleeding during surgery in the maxillary posterior region.

Identification of Posterior Superior Alveolar Artery During Direct Sinus Floor Elevation: A Cone Beam Computed Tomography Radiographic Study

Identification of Posterior Superior Alveolar Artery During Direct Sinus Floor Elevation: A Cone Beam Computed Tomography Radiographic Study

Localization of the position of vital anatomical structures in the lateral wall of maxillary sinus during different surgical intervention using cone beam computed tomography

Background: Proper information about the anatomy of the maxillary sinus is required to avoid any unexpected complications that may arise due to the close relation between the maxillary sinus and posterior superior alveolar artery. Objective: To the current study used cone beam computed tomography CBCT imaging to assess the position of the posterior superior alveolar artery (PSAA) in relationship to the alveolar ridge and the flour of maxillary sinus. Patients and Methods: A number of 95 Iraqi patients participated in this prospective study (53 females, 42 males; age range 20-49 years). From January 2021 to February 2022, attended a 2nd specialised dentistry institution in Baquba city for CBCT scanning for numerous diagnostic and management purposes. Results: According to our study, we detected the presences of artery in (83.68%) of the sample. females showed higher PSAA prevalence than men on both sides, and the difference was significant overall, Also, the existence of artery for each side and total in the intramembranous locating in females is greater than that in males, which may demonstrate that the probability of Bleeding and other side effects is higher in males, since the existence of artery in the intramembranous area in females will reduce the likelihood of traumatic injury throughout any surgical treatment. Conclusion: This research used CBCT to determine the precise location of PSAA in the Iraqi population. This data could assist in decreasing the likelihood of hemorrhage as well as other complications which may happen throughout any surgical treatment, such as dental implant placement, ridge expansion.As well as other surgical interventions in this region. Keywords: Maxillary sinus walls, posterior superior alveolar artery, cone beam computed tomography

Localization of the position of vital anatomical structures in the lateral wall of maxillary sinus during different surgical intervention using cone beam computed tomography

Background: Proper information about the anatomy of the maxillary sinus is required to avoid any unexpected complications that may arise due to the close relation between the maxillary sinus and posterior superior alveolar artery.&#x0D; Objective: To the current study used cone beam computed tomography CBCT imaging to assess the position of the posterior superior alveolar artery (PSAA) in relationship to the alveolar ridge and the flour of maxillary sinus.&#x0D; Patients and Methods: A number of 95 Iraqi patients participated in this prospective study (53 females, 42 males; age range 20-49 years). From January 2021 to February 2022, attended a 2nd specialised dentistry institution in Baquba city for CBCT scanning for numerous diagnostic and management purposes.&#x0D; Results: According to our study, we detected the presences of artery in (83.68%) of the sample. females showed higher PSAA prevalence than men on both sides, and the difference was significant overall, Also, the existence of artery for each side and total in the intramembranous locating in females is greater than that in males, which may demonstrate that the probability of Bleeding and other side effects is higher in males, since the existence of artery in the intramembranous area in females will reduce the likelihood of traumatic injury throughout any surgical treatment.&#x0D; Conclusion: This research used CBCT to determine the precise location of PSAA in the Iraqi population. This data could assist in decreasing the likelihood of hemorrhage as well as other complications which may happen throughout any surgical treatment, such as dental implant placement, ridge expansion.As well as other surgical interventions in this region.

Automatic detection of posterior superior alveolar artery in dental cone-beam CT images using a deeply supervised multi-scale 3D network.

This study aimed to develop a robust and accurate deep learning network for detecting the posterior superior alveolar artery (PSAA) in dental cone-beam CT (CBCT) images, focusing on the precise localization of the centre pixel as a critical centreline pixel. PSAA locations were manually labelled on dental CBCT data from 150 subjects. The left maxillary sinus images were horizontally flipped. In total, 300 datasets were created. Six different deep learning networks were trained, including 3D U-Net, deeply supervised 3D U-Net (3D U-Net DS), multi-scale deeply supervised 3D U-Net (3D U-Net MSDS), 3D Attention U-Net, 3D V-Net, and 3D Dense U-Net. The performance evaluation involved predicting the centre pixel of the PSAA. This was assessed using mean absolute error (MAE), mean radial error (MRE), and successful detection rate (SDR). The 3D U-Net MSDS achieved the best prediction performance among the tested networks, with an MAE measurement of 0.696 ± 1.552 mm and MRE of 1.101 ± 2.270 mm. In comparison, the 3D U-Net showed the lowest performance. The 3D U-Net MSDS demonstrated a SDR of 95% within a 2 mm MAE. This was a significantly higher result than other networks that achieved a detection rate of over 80%. This study presents a robust deep learning network for accurate PSAA detection in dental CBCT images, emphasizing precise centre pixel localization. The method achieves high accuracy in locating small vessels, such as the PSAA, and has the potential to enhance detection accuracy and efficiency, thus impacting oral and maxillofacial surgery planning and decision-making.

Posterior superior alveolar artery – an anatomical and clinical case report

Abstract During a routine dissection of infratemporal fossa on educational purposes abnormality of posterior superior alveolar artery was found. This abnormality stays in relation to atypical anatomy of the facial artery in this cadaver. Such an unusual course of branches may have a profound meaning during surgery in the infratemporal and facial area and might have educational value. A case report was conducted using routine dissection techniques, and the material was accessed through a local informed donation program.

Alveolar antral artery: cone beam computed tomography study and clinical context.

Anastomosis between posterior superior alveolar artery and infraorbital artery can go through bony canal in the lateral wall of the maxilla. This artery is called alveolar antral artery. It can complicate lateral sinus lift procedure by bleeding and hemosinus formation or bone graft wash out. The artery can also go in soft tissues where is not visible on cone beam computed tomography. In previous studies, the relation of this artery to sinus floor or alveolar process was measured. These structures are highly unstable during lifetime and after tooth loss. The aim of this study is to study presence and relations of bony canal in the lateral maxillary wall, to characterize the group of patients which is more likely to have bone canal in the lateral maxilla. The aim and the novelty of this study is the describing of the relationship of the bony canal to the more stable structure of hard palate and describing the relation of presence of bony canal on width of maxillary sinus, and to facilitate the prediction of presence of the alveolar antral artery. The cone beam computed tomography scans of the patients (251 in number) of the university hospital were examined for presence of alveolar antral artery (148 was fulfilled inclusion criteria), patient were characterized by gender, age, and sinus type (wide, average, narrow). The diameter of the bony canal and its relation to the level of sinus floor and hard palate were measured. The cone beam computed tomography scans of 148 patients, out of it 55 man (37,2%) and 93 women (62,8%). Bony canal containing alveolar anastomosis was found in 69 cases (57,0%). Presence of the bony canal in the lateral wall of maxillae showed statistical probability depending on age with p=0,064 according to Mann-Whitney test. The older patients have more likely the bony canal. The presence of the alveolar antral artery was found more likely in the wide sinuses. The hard palate level can serve as a prediction point of alveolar antral artery only in first molar and second premolar region. In accordance with previous studies the width of bony canal is significantly higher in group of man (p=0,015). There was found a correlation between smaller distance of bony canal from sinus floor in the presence of teeth (p=0,067). After tooth loss the distance between sinus floor and bony canal increases, but the distance of bony canal to hard palate level stays constant. This can be explained hypothetically so that periodontal ligaments and root surface acts as a barrier for sinus pneumatization. Lateral sinus lifting in some cases can be unenviable, the knowledge about alveolar antral artery anatomy can reduce the risk of arterial bleeding. The cone-beam computed tomography is a routine examination prior to augmentation surgery and therefore the data obtained from it has an impact on clinical practice.

Evaluation of the Locations of Posterior Superior Alveolar Artery and Lingual Foramen in Cone Beam Computed Tomography Before Dental Implant Treatment

Aim: This study aimed to evaluate the locations of the lingual foramen and posterior superior alveolar artery (PSAA) and their distances from the alveolar crest and maxillary sinus floor using cone-beam computed tomography (CBCT).&#x0D; Material and method: In this study, 136 patients underwent CBCT:1) The PSAA's proximity to the alveolar crest and sinus floor, its position on the lateral wall of the maxillary sinus, and 3) the distance from the lingual foramen to the alveolar crest borders.&#x0D; Results: Gender caused a significant difference in the distance of the PSAA from the alveolar crest (p

Maxillary sinuses, multiple aspects to consider prior to bone grafting procedure: a retrospective study in a sample of a Palestinian population.

To analyze various anatomical aspects of the maxillary sinuses on CBCT volumes, mainly, the posterior superior alveolar artery (PSAA), and to compare its visibility on CBCT vs. panoramic radiographs. A retrospective radiographic analysis was conducted on 120 patients (240 maxillary sinuses) using their CBCT coronal views (CCV) and panoramic radiographs (CP). On CCV, the PSAA's maximum dimension (MD), vertical distance (PVD) to the alveolar crest, and bone plate thickness (T1 and T2) buccally and inferiorly to the PSAA, respectively, were analyzed. Additionally, on CCV, the ostium vertical distance (OVD) and location were recorded, and the height of the remaining bone height inferior to the maxillary sinuses (MVD) was also measured. The PSAA's visibility was evaluated and compared between CCV and CP. All these variables were studied at the apical region of the second maxillary premolar (P2), first molar (M1), and second molar (M2). Age, gender, and face side (right vs. left) factors affecting the sinus dimensions and visibility were investigated. Several statistical tests were used to analyze these variables. PSAA was detected in 96.53% of the records on CCV, where it was significantly superior to CP in the detection of the PSAA structure (p value 0.000) at all sites analyzed. The PSAA's MD, PVD, T1 and T2 thicknesses, and MVD were on average 1.19mm, 19.54mm, 0.69mm, 1.36mm, and 10.25, respectively. OVD average was 31.04mm where 42.9% of the ostia were within the mesiodistal extent of the second upper molar. No significant relation was found between different age groups, gender, and the visibility level of PSAA. Age, gender, and the side of the face investigated showed no discernible effects on the maxillary sinus's bone thickness, vertical dimensions, or PSAA diameter among the studied Palestinian sample. As CCV was superior to CP in the identification of PSSA, preoperative evaluation of PSSA using CBCT volumes is thus recommended.

Management of Mid-Facial Fracture Complicated by Pseudoaneurysm of Posterior Superior Alveolar Artery.

Facial fractures, particularly mid-facial fractures, can result in various complications, such as functional and esthetic problems. Prompt reconstruction of the fractured bones is crucial for restoring normal anatomy and function and preventing complications. However, such procedures can be complex and carry the risk of potential complications. The authors report the case of a 27-year-old man who underwent open reduction and internal fixation of the left zygomatic complex fracture and reconstruction of the left inferior orbital wall. During the surgery, heavy bleeding from the posterior superior alveolar artery due to a broken bone near the pterygomaxillary region caused a prolonged surgery time and the development of a pseudoaneurysm. The pseudoaneurysm was eventually treated with superselective transcatheter embolization using 25% N-Butyl cyanoacrylate glue. This case highlights the challenges in the management of mid-facial fractures and the potential complications that can arise during surgery, particularly when dealing with the pterygomaxillary region.

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

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.

Frequency, location, and diameter of the anastomosis between the posterior superior alveolar artery and the infraorbital artery in imaging studies: systematic review and meta-analysis.

The anastomosis between the posterior superior alveolar artery (PSAA) and the infraorbital artery (IOA) courses along half of the lateral wall of the maxillary sinus. Risk of injury to the anastomosis between PSAA and IOA during surgical procedures has been reported. The aim of the present study was to carry out a systematic review and meta-analysis to determine the frequency, location, and diameter of the anastomosis between PSAA and IOA in imaging studies (cone-beam computed tomography, spiral cone-beam computed tomography, and computed tomography). A search was carried out in the PubMed, EMBASE, and LILACS. Original works were included reporting imaging studies to analyze the frequency, location, and diameter of the anastomosis in humans. The risks of bias were analyzed using the AQUA tool. Generalized linear mixed models were used to estimate the frequency and the 95% CI in the meta-analysis. The variance in prevalence estimates was stabilized by logit transformation. The qualitative analysis included 49 studies with 10,837 patients. The frequency of the anastomosis between PSAA and IOA was 74% (prediction interval 0.20-0.97%). The anastomosis was most frequently located in the intraosseous region (60.0%), followed by the submembranous region (33.0%), and least frequently in an extraosseous location (5.0%). Arteries with diameter of 1.0-1.9mm were most frequent (32.0%), followed by arteries with diameter less than 1mm (23.0%); a small number with diameter greater than 2mm was recorded (4.0%). These data can be used as a reference to help surgeons when planning interventions in the lateral wall of the maxillary sinus. Registration number: INPLASY, number 202120071.

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

This systematic review examined the detection of the posterior superior alveolar artery, along with various anatomic characteristics, on cone-beam computed tomography images. Studies were identified electronically through the Web of Science, MEDLINE, Scopus, and Embase databases. The quality of the included studies was evaluated using a 5-item binary scale. The detection rate, location, and classified diameter of the posterior superior alveolar artery were estimated as prevalence values. The diameter of this artery, as well as the distances from the artery to the alveolar crest and sinus floor, were estimated as means with associated 95% confidence intervals. Thirty-seven studies were enrolled, with 34 of these included in the meta-analysis. The mean detection rate was 79% (range: 72%-84%), and the mean diameter was 1.06±0.05 mm (range: 0.96-1.16 mm). The posterior superior alveolar artery was located intraosseously in 64% of cases. The mean distance of the artery from the alveolar crest was 16.71±0.49 mm (range: 15.75-17.68 mm), while the mean distance from the artery to the sinus floor was 8.85±0.4 mm (range: 8.05-9.64 mm). According to the findings of this meta-analysis regarding various anatomic characteristics of the posterior superior alveolar artery, severe hemorrhage after damage to this artery during sinus augmentation procedures is not a substantial clinical problem.

Evaluation of posterior superior alveolar artery using cone-Beam computed tomography in the Indian population: A retrospective study

Evaluation of posterior superior alveolar artery using cone-Beam computed tomography in the Indian population: A retrospective study

Anatomic Situation of Posterior Superior Alveolar Artery in Cone-Beam Computed Tomography Images in Maxillary Molar Region

Introduction: Bleeding is an important complication during implant placement. The aim of this study was to evaluate the anatomic situation of the posterior superior alveolar artery (PSAA) in cone-beam computed tomography (CBCT) images in maxillary molar region in an Iranian population.&#x0D; Methods: In this descriptive cross-sectional study, CBCT scans of the edentulous regions of the posterior maxilla were participants to examine the location and anatomical features of the PSAA. 300 CBCT scans of patients with the mean age of 48.79 years were used. The CBCT scans had been obtained by Scanora 3D (Soredex, Tuusula, Finland). The diameter and the PSAA distance to the alveolar crest was measured by OnDemand 3D software on cross sectional and coronal sections. Data were analyzed through the Chi-Square, T-Test, ANOVA and Exact Fisher tests using the SPSS software (version 23).&#x0D; Results: Out of 300 images, the PSAA was observed in 203 (67.6%) ones. The artery was slightly more observable in males (68.8%) compared to females (66.4%). Although the difference was not significant (p-value: 0.711). The mean artery diameter and distance to alveolar crest were higher in males (1.33±0.64 mm; 18.016±4.78 mm, respectively) compared to females (1.12 ±0.47 mm; 17.885±4.31 mm). Only the difference between the diameters was significant (p-value: 0.008).&#x0D; Conclusion: According to this study, with the increase of age, the diameter and distance of the artery to bone crest decreases. The mean artery diameter and distance to bone crest is higher in males compared to females.

Anatomical variations and accessory structures in the maxilla in relation to implantological procedures: an observational retrospective study of 212 cases using cone-bean computed tomography

PurposeThis study used cone-beam computed tomography (CBCT) to analyze the prevalence of several maxillary anatomical/accessory structures, as well as variations within each type, assessing how accurate diagnosis can minimize the risk of intraoperative complications during implantological procedures in the oral cavity.Methods212 CBCT scans of the maxilla were analyzed, captured over a period of 18 months for surgical planning purposes. The prevalence of posterior superior alveolar arteries (PSAA), maxillary sinus septa (MSS), and branches of the canalis sinuosus (CS) were evaluated, as were the diameter and location of each anatomical structure in horizontal and vertical planes. P < 0.05 was considered statistically significant.ResultsPSAAs were observed in 99.1% of cases, the intrasinus type being the most frequent; MSS were noted in 15.6% of the sample, mainly in the posterior region with sagittal orientation; CS branches were observed in 50% of patients, mainly in relation to the incisors and significantly more prevalent among males.ConclusionsThe use of CBCT significantly increases the possibility of clearly identifying these anatomical structures. The differences found between patients highlight the importance of carrying out an exhaustive radiological study of the individual to prevent complications, such as Schneiderian membrane perforation, neurovascular damage or bleeding during surgery.Graphical

The Use of CBCT in Evaluating the Health and Pathology of the Maxillary Sinus.

The use of cone-beam computed tomography (CBCT) has been increasing in dental practice. This narrative review summarized the relevance and utilizations of CBCT to visualize anatomical structures of the maxillary sinus and common pathologies found in the maxillary sinus. The detection/visualization rate, the location and the morphometric characteristics were described. For sinus anatomy, the reviewed features included the posterior superior alveolar artery, sinus pneumatization, sinus hypoplasia, sinus septa, and primary and accessory sinus ostia. For pathology, the following items were reviewed: membrane thickening associated with periapical lesions/periodontal lesions, mucous retention cyst, and antrolith. The visualization and assessment of the maxillary sinus is very important prior to procedures that take place in close proximity with the sinus floor, such as tooth extraction, implant insertion, and sinus floor elevation. Some sinus pathologies may be associated with odontogenic lesions, such as periapical diseases and periodontal bone loss.

Anatomical localization of posterior superior alveolar artery: A retrospective study by cone-beam computed tomography.

Familiarity with the anatomy of the arteries in the sinus wall is essential to prevent the perforation of the sinus membrane and bleeding during dental implant surgery. The aim of the study was to evaluate the anatomical position of the posterior superior alveolar artery (PSAA), using cone-beam computed tomography (CBCT). A total of 245 CBCT scans met the eligibility criteria for this cross-sectional study. The vertical distance from the lower border of the artery to the lower border of the sinus floor, the diameter of the artery, and the type of artery (intrasinusoidal, intraosseous or superficial) in the first and second premolar and molar regions were measured. The data was analyzed with the t tests, the one-way analysis of variance (ANOVA) and the χ2 tests. The maxillary PSAA was recognized in 187 (76.3%) scans. The mean distance between the artery and the floor of the sinus was 6.87 ±3.68 mm. The mean diameter of the artery was 1.37 ±0.61 mm. The greatest mean diameter of the artery was observed in the second premolar region, and the smallest in the first molar region. As many as 63.6% of the arteries were intraosseous, 28.9% intrasinusoidal, and 7.5% superficial. Due to the high prevalence of the intraosseous type, in most cases of sinus lift surgery there is an increased possibility of PSAA damage. As the largest diameter of the artery was observed in the second premolar region, the possibility of severe bleeding during sinus lift surgery in this area is increased. The average distance between the artery and the floor of the sinus was approx. 7 mm. Consequently, it is recommended that the lower border of the sinus access window should be as high as 7 mm to the floor of the sinus.