Search Results (7)

Background/Objectives: Sinus elevation in the posterior maxilla carries a risk of hemorrhage due to injury of the posterior superior alveolar artery (PSAA). Accurate preoperative identification of the PSAA using cone-beam computed tomography (CBCT) can enhance surgical safety. This retrospective study evaluated the prevalence, location, diameter, and visibility of the PSAA in a Saudi population. Methods: A total of 117 CBCT scans (234 sinuses) obtained between 2022 and 2024 were analyzed. The PSAA’s visibility, diameter, and distances from the alveolar crest, sinus floor, medial wall, and sinus septa were measured. Associations with age, sex, smoking status, and the presence of sinus septa were statistically assessed. Results: The PSAA was identified in 98.3% of sinuses. Intraosseous and submucosal locations predominated in premolar and molar regions, respectively. Class A arteries (≤1 mm) were most frequent. Significant differences were found between premolar and molar regions in arterial location and distances from the alveolar crest and sinus walls (p < 0.001). Older individuals exhibited medial displacement of the artery in the molar region, and smokers showed significantly smaller diameters (p < 0.05). Sinus septa were associated with increased PSAA distances from the sinus floor and medial wall. Conclusions: The PSAA demonstrates high detectability and marked variability in position and caliber within this Saudi cohort. Recognition of these anatomical variations is essential for reducing complications during sinus-augmentation procedures. Full article

In this study, we investigated the anatomical location, dimensions, and relationships of the posterior superior alveolar artery (PSAA) and canalis sinuosus (CS) within the maxilla, aiming to enhance the safety and efficacy of surgical procedures. A retrospective analysis was performed on 323 individual cone beam computed tomography scans. The diameter of the PSAA and CS, the distance of the PSAA from the sinus floor, the distance of the PSAA and CS from the alveolar crest, the distance of the PSAA and CS from the nasal septum, and the distance from CS to the nasal cavity floor were measured. The distance between PSAA and the sinus floor showed no significant difference between the right and left sides nor between genders (p < 0.05). The distance between the alveolar crest of PSAA and the distance between PSAA and to nasal septum was significantly higher on the left than on the right side (p < 0.05). According to gender, female subjects exhibited a lower distance between PSAA and the nasal septum than males (p < 0.05). Variations in PSAA and CS anatomy highlight the need for individualized preoperative CBCT assessment to reduce complications like bleeding during maxillary surgeries, enhancing surgical planning and safety in dental and maxillofacial procedures. Full article

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. Full article

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. Full article

Background: Various anatomical parameters might influence the surgical approach for maxillary sinus floor elevation. The objective of the present study was to retrospectively evaluate the influence of anatomical parameters on the dimensions of the subantral space and of the sinus mucosa thickening after sinus floor elevation. Material and Methods: Seventy-eight maxillary sinuses in sixty-five patients were evaluated on cone beam computed tomographies taken before surgery and after one week (t1w) and nine months (t9m). Several parameters such as the distance XF between an axis parallel to the base of the nose (X-axes) and the sinus floor (F) were correlated with the height gain (IF) at t1w and t9m and the post-surgical edema. Results: A weak significant positive correlation was observed between height gain vs. sinus height of interest (XF), the balcony, and the sinus floor angle. The post-surgical edema was influenced by the initial mucosa thickness and the xenograft used. Conclusions: Various parameters might affect height gain and sinus mucosa thickening after sinus floor elevation. The height of interest, the balcony, and the sinus floor angle showed significant correlations with height gain. The initial thickness of the mucosa and the biomaterial used influenced the post-surgical edema. Full article

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. Full article

The Posterior Superior Alveolar Artery (PSAA) provides vascular support to molars, gingiva, and maxillary sinus. A tear of the PSAA may cause profuse hemorrhages which may lead to complications at a surgical level. As such, it becomes crucial to anatomically analyse several features regarding the PSAA as well as the area surrounding it. In this paper, we are particularly interested in the study of the complexity of the periodontal tissue structure which appears close to the location of the PSAA. A total amount of 400 cone beam computed tomography (CBCT) scans (two per subject) were performed to explore the presence of the PSAA, the thickness of the Schneider’s membrane, and the existence of septa. Several parameters were evaluated including the location of the artery in the maxillary sinus, the distance from the PSAA to the alveolar ridge, the thickness of the membrane, the diameter of the cavities produced by the septa, and the fractal dimension of the trabecular tissue that surrounds the PSAA. They were found strong linear relationships between Distal and Central Measures (a Pearson’s $R^2=0.9952$ ), Mesial and Central Measures ( $R^2=0.9950$ ), and Distal and Mesial Measure ( $R^2=0.997$ ). We hypothesised that the loss of dental pieces would imply a distinct complexity of the trabecular tissue structure surrounding the PSAA. In this way, a p-value equal to $0.001$ was provided by the Mann-Whitney test, which supports our hypothesis. Furthermore, the mean of the fractal dimensions of the group of edentulous patients (equal to $1.56$ ) was found to be lower than the one of the group of non-edentulous patients (equal to $1.61$ ) with small standard deviations in both cases. Our study suggests that accurate calculations of the fractal dimension combined with the use of CBCT do provide valuable information regarding the area that surrounds the PSAA. Full article