The Radiological Evaluation of Posterior Superior Alveolar Artery by Using CBCT.

2020 ◽  
Vol 16 ◽  
Author(s):  
Hazal Karslioglu ◽  
Mesude Çitir ◽  
Kaan Gunduz ◽  
Pelin Kasap
Keyword(s):  
Maxillary Sinus ◽  
Nasal Septum ◽  
Sinus Lift ◽  
Alveolar Crest ◽  
Sinus Wall ◽  
Perioperative Bleeding ◽  
Anatomical Relationship ◽  
Exact Position ◽  
Inferior Border ◽  
Maxillary Region

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.

scholarly journals Position of posterior superior alveolar artery in relation to the maxillary sinus using cone beam computed tomography in Indian sub-population

2021 ◽  
Vol 27 (3) ◽  
pp. 34
Author(s):  
Aamir Zahid Godil ◽  
Trupti Jagannath Devadiga ◽  
Shraddha Chandrashekhar Supnekar ◽  
Arshi Ilyas Kazi ◽  
Sanaa Akhlaq Wadwan ◽  
...  
Keyword(s):  
Maxillary Sinus ◽  
Radiographic Measurement ◽  
Vertical Position ◽  
Lateral Sinus ◽  
Outer Cortex ◽  
Linear Measurements ◽  
Lower Border ◽  
Alveolar Crest ◽  
Sinus Wall ◽  
The Mean

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.

Transnasal Endoscopic Medial Maxillary Sinus Wall Transposition with Preservation of the Inferior Turbinate and Nasolacrimal Duct

2015 ◽  
Vol 76 (S 01) ◽  
Author(s):  
Alice Zhao ◽  
Kristina Piastro ◽  
Anna Butrymowicz ◽  
Tiffany Chen ◽  
Tyler Kenning ◽  
...  
Keyword(s):  
Maxillary Sinus ◽  
Inferior Turbinate ◽  
Nasolacrimal Duct ◽  
Sinus Wall

Axial Triangle of the Maxillary Sinus, and its Surgical Implication With the Position of Maxillary Sinus Septa During Sinus Floor Elevation: A CBCT Analysis

2020 ◽  
Vol 46 (4) ◽  
pp. 415-422
Author(s):  
Junho Jung ◽  
Jung Soo Park ◽  
Seoung-Jin Hong ◽  
Gyu-Tae Kim ◽  
Yong-Dae Kwon
Keyword(s):  
Maxillary Sinus ◽  
Surgical Techniques ◽  
Lateral Sinus ◽  
Sinus Floor Elevation ◽  
Second Molar ◽  
Sinus Wall ◽  
Posterior Maxilla ◽  
Significant Difference ◽  
Sinus Floor ◽  
Molar Region

The aim of this study was to measure the convexity of the lateral wall of the maxillary (Mx) sinus and identify the locational distribution of antral septa in relation to the zygomaticomaxillary buttress (ZMB), in order to suggest another anatomical consideration and surgical modification of sinus floor elevation procedures. This study was designed as a cross-sectional study, and a total of 134 patients and 161 sinuses containing edentulous alveolar ridges were analyzed. The angle between the anterior and lateral walls of the Mx sinus (lateral sinus angle [LSA]), and the angle between the midpalatal line and the anterior sinus wall (anterior sinus angle [ASA]) were measured. Mean LSAs and ASAs were 105.9° ± 9.86° and 58.4° ± 6.43°, respectively. No significant difference between left and right sides was found (LSA, P = .420; right = 105.5° ± 9.27°; left = 105.5° ± 9.27° and ASA, P = .564; right = 57.9° ± 6.80°; left = 58.8° ± 6.02°). The prevalence of septa was 37.3%, and it was most frequently noted in the second molar region (32.8%), followed by the first molar (20.9%), retromolar (16.4%), and second premolar regions (14.9%). Septa were most frequently located posterior to the ZMB (49.2%), while ZMB was mostly located in the first molar region (66.4%). Narrow LSAs may complicate the surgical approach to the posterior maxilla, especially when sinus elevation should be used in the second molar region. Considering the occasional presence of antral septa, membrane elevation may be complicated when a septum is encountered during the procedure. These results suggest that 3-dimensional examination of the convexity of the Mx sinus should be performed preoperatively to choose proper surgical techniques and minimize surgical complications.

Imaging study of the anatomical variations and the maxillary sinus pathology in patients with missing lateral teeth for the application of dental implants

ORL ro ◽  
2016 ◽  
Vol 1 (1) ◽  
pp. 6-12
Author(s):  
Iulian Damian ◽  
Gheorghe-Ionel Comșa
Keyword(s):  
Computed Tomography ◽  
Maxillary Sinus ◽  
Dental Implants ◽  
Preoperative Evaluation ◽  
Anatomical Variations ◽  
Accurate Information ◽  
Maxillary Artery ◽  
Lateral Sinus ◽  
Sinus Wall ◽  
Increased Risk

Preoperative evaluation of maxillary sinus anatomy is very important to avoid surgical complications due to close anatomical relations between the sinus and the posterior maxillary teeth and/or edentulous alveolar ridge. Posterior superior alveolar artery is a branch of the maxillary artery and provides the vascularization of the lateral sinus wall and underlying mucosa. Maxillary artery branches should be taken into consideration during sinus lifting procedures and bone augmentation due to increased risk of bleeding by damaging the artery during the osteotomy. Computed tomography (CT) explores three-dimensional anatomic structures and provides complex and accurate information about them. Cone Beam Computed Tomography (CBCT) offers an accurate view of the teeth and surrounding structures at high resolution, despite low-dose radiation used. In this study, the incidence of anatomical variations and sinus pathology were assessed using CBCT. The aim is to evaluate the presence of sinus pathology (sinus mucosal thickening, oro-antral communications, sinus tumors, cysts, polyps), presence and position of the posterior superior alveolar artery. These issues are important because they are about the limits of the dental implants in the posterior maxillary area. The presence of sinus pathology and anatomical variations may predispose to complications and even failures of implantation therapy.  

scholarly journals Evaluating Endoscopic Ipsilateral Endonasal Corridor Approaches to the Anterolateral Wall of the Maxillary Sinus: A Computerized Tomography Study

2021 ◽  
Author(s):  
Navarat Vatcharayothin ◽  
Pornthep Kasemsiri ◽  
Sanguansak Thanaviratananich ◽  
Cattleya Thongrong
Keyword(s):  
Confidence Interval ◽  
Maxillary Sinus ◽  
Inferior Turbinate ◽  
Radial Access ◽  
Sinus Wall ◽  
Nasal Floor ◽  
Significant Difference ◽  
Anterolateral Wall ◽  
The Mean ◽  
Maxillary Sinuses

Abstract Introduction The endoscopic access to lesions in the anterolateral wall of the maxillary sinus is a challenging issue; therefore, the evaluation of access should be performed. Objective To assess the accessibility of three endoscopic ipsilateral endonasal corridors. Methods Three corridors were created in each of the 30 maxillary sinuses from 19 head cadavers. Accessing the anterolateral wall of the maxillary sinus was documented with a straight stereotactic navigator probe at the level of the nasal floor and of the axilla of the inferior turbinate. Results At level of the nasal floor, the prelacrimal approach, the modified endoscopic Denker approach, and the endoscopic Denker approach allowed mean radial access to the anterolateral maxillary sinus wall of 42.6 ± 7.3 (95% confidence interval [CI]: 39.9–45.3), 56.0 ± 6.1 (95%CI: 53.7–58.3), and 60.1 ± 6.2 (95%CI: 57.8–62.4), respectively. Furthermore, these approaches provided more lateral access to the maxillary sinus at the level of the axilla of the inferior turbinate, with mean radial access of 45.8 ± 6.9 (95%CI: 43.3–48.4) for the prelacrimal approach, 59.8 ± 4.7 (95% CI:58.1–61.6) for the modified endoscopic Denker approach, and 63.6 ± 5.5 (95%CI: 61.6–65.7) for the endoscopic Denker approach. The mean radial access in each corridor, either at the level of the nasal floor or the axilla of the inferior turbinate, showed a statistically significant difference in all comparison approaches (p < 0.05). Conclusions The prelacrimal approach provided a narrow radial access, which allows access to anteromedial lesions of the maxillary sinus, whereas the modified endoscopic Denker and the endoscopic Denker approaches provided more lateral radial access and improved operational feasibility on far anterolateral maxillary sinus lesions.

scholarly journals Floating septum technique: easy and safe method maxillary sinus septa in sinus lifting procedure

2019 ◽  
Vol 41 (1) ◽  
Author(s):  
Junho Jung ◽  
Bo-Yeon Hwang ◽  
Byung-Soo Kim ◽  
Jung-Woo Lee
Keyword(s):  
Maxillary Sinus ◽  
Maxillary Sinusitis ◽  
Sinus Lift ◽  
Sinus Floor Elevation ◽  
Schneiderian Membrane ◽  
Safe Method ◽  
Membrane Perforation ◽  
Sinus Lifting ◽  
Maxillary Sinus Septa ◽  
Sinus Floor

Abstract Background The presence of septa increases the risk of Schneiderian membrane perforation during sinus lift procedure, and therefore, the chance of graft failure increases. We present a safe method of managing septa and, in particular, overcoming small and palatally located septa. Methods After the elevation of the flap and the creation of a small bony window positioned anterior to the septum, the Schneiderian membrane is lifted carefully. A thin and narrow osteotome is then placed at the indentation created at the base of the septum, and mobilization of the septum is achieved by gentle malleting. The membrane is again carefully lifted up behind the septum. Results There was one small membrane perforation case in all 16 cases, and none of these patients showed postoperative complications such as implant failure, infection, or maxillary sinusitis. Conclusions This technique is useful for overcoming the problem of maxillary sinus septa hindering the sinus floor elevation procedure, leading to fewer complications.

scholarly journals 3D Volumetric Analysis and Anatomical Considerations for Sinus Bone Graft

2021 ◽  
Vol 11 (3) ◽  
pp. 951
Author(s):  
Ji Hyoung Kim ◽  
Hyo Joon Kim ◽  
Ye Joon Jo ◽  
Jun Seok Choi ◽  
Seong Yong Moon
Keyword(s):  
Bone Graft ◽  
Maxillary Sinus ◽  
Alveolar Bone ◽  
Lateral Wall ◽  
Volumetric Analysis ◽  
Ct Scans ◽  
Sinus Floor Elevation ◽  
Sinus Wall ◽  
Sinus Floor ◽  
The Mean

The aim of this study is to evaluate anatomical considerations and assess the volume of the maxillary sinus bone graft. There were sixty-three patients (eighty-three sinuses) who had taken CT scans for implant surgery. Patients included those whose height of the residual alveolar bone was less than 5 mm. The position of posterior superior alveolar artery, the thickness of the maxillary sinus wall, and the volume of the maxillary sinus according to the amount of sinus floor elevation were measured. The mean vertical distance of posterior superior alveolar artery was 11.91 ± 4.79 mm from 3.03 mm to 24.05 mm. The mean thickness of the lateral wall was 1.71 ± 0.55 mm in the range of 0.74 mm to 3.93 mm. The volume of 3 mm, 5 mm, 7 mm, and 10 mm from the sinus floor was 0.173 ± 0.11 cm3, 0.526 ± 0.25 cm3, 1.068 ± 0.43 cm3, and 2.184 ± 0.74 cm3 on average, respectively. The knowledge of the posterior superior alveolar artery position, the lateral wall thickness, and the volume of the maxillary sinus can help the clinician for sinus bone graft.

Ameloblastoma of the maxillary sinus: conservative surgical management considering high recurrence risk potential

2021 ◽  
Vol 14 (5) ◽  
pp. e241487
Author(s):  
Lukas S Fiedler ◽  
Annette Wunsch
Keyword(s):  
Maxillary Sinus ◽  
Radical Resection ◽  
Recurrence Risk ◽  
Flexible Endoscopy ◽  
Cystic Mass ◽  
High Rate ◽  
Sinus Surgery ◽  
Nasal Passage ◽  
Lateral Sinus ◽  
Sinus Wall

Ameloblastoma (AM) in the maxillary sinus is rare. This benign entity shows locally invasive, destructive and aggressive behaviour and a high rate of recurrence. Therefore, the course of treatment is radical resection. We report the case of a 38-year-old man presenting with signs of recurrent sinusitis in the Ear, Nose and Throat Department. Transnasal flexible endoscopy revealed a cystic mass in the right inferior and middle nasal passage. CT scan showed an obliterated right maxillary sinus with a ballooning effect and pressure atrophy of the lateral sinus wall, without possible differentiation of the middle and low nasal turbinate. The patient was treated with transnasal functional sinus surgery; pathology stated AM. AM in the maxillary sinus is rare, locally destructive and therefore as a gold standard is resected radically to prevent recurrence. We demonstrate a conservative approach; explicitly, we combined a transvestibular and functional endoscopic sinus surgery resection of the AM to maintain function and reduce the possibility of postoperative impairments. Whether the strategy of treatment for AM is conservative, it nonetheless can result in a recurrence-free status. Nevertheless, inclusion into an oncological follow-up-programme with regularly performed MRI and CT is recommended.

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