Distance of the alveolar antral artery from the alveolar crest. Related factors and surgical considerations in sinus floor elevation

  1. Pablo Ignacio Varela Centelles 1
  2. María Loira Gago 2
  3. Antonio González Mosquera 2
  4. Juan M. Seoane Romero 2
  5. J.M. García Martín 3
  6. Juan Manuel Seoane Lestón 2
  1. 1 C.S. Praza do Ferrol. EOXI Lugo, Cervo e Monforte de Lemos. Galician Health Service. Pza. Ferrol 11. 27001 Lugo. Spain; Stomatology Department. School of Medicine and Dentristry. University of Santiago de Compostela. Entrerríos s/n. 15782. Santiago de Compostela. A Coruña. Spain
  2. 2 Stomatology Department. School of Medicine and Dentristry. University of Santiago de Compostela. Entrerríos s/n. 15782. Santiago de Compostela. A Coruña. Spain
  3. 3 Department of Medicine and Medical-Surgical Specialities. School of Medicine and Health Sciences. University of Oviedo. C/ Julián Clavería s/n. 33006. Oviedo. Spain
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Journal:
Medicina oral, patología oral y cirugía bucal. Ed. inglesa

ISSN: 1698-6946

Year of publication: 2016

Volume: 21

Issue: 6

Pages: 9

Type: Article

DOI: 10.4317/MEDORAL.21475 DIALNET GOOGLE SCHOLAR lock_openOpen access editor

More publications in: Medicina oral, patología oral y cirugía bucal. Ed. inglesa

Abstract

In a variable proportion of maxillary sinuses alveolar antral artery is located close to the residual ridge, increasing the chances for haemorrhagic complications during sinus floor elevation procedures. Retrospective observational study of CBCT explorations performed for implant-treatment planning. The upper first molar area was selected for this study. The relative uncertainty (standard deviation of the measurement divided by its mean and expressed as a percentage from 0% to 100%) was chosen for determining the observational errors. For modeling the chances of AAA detection, the generalized additive models (GAM) approach was chosen. A total of 240 maxillary sinuses were studied (46.25% males) whose median median age was 58 years old (IQR: 52-66). Univariate models showed that the chances for an AAA-alvelar crest distance ≤15mm increase in wider sinuses with lower, subsinusally edentulous crests. When distance is considered as a continuous variable, the best mutivariate model showed an explained deviance of 67% and included AAA diameter, distance AAA-sinus floor, sinus width, and shape, height and width of the residual ridge. Thinner AAAs are found closer to the crest (within the ≤15mm safe distance). Bearing in mind the inclusion criteria and the limitations of this investigation, it is concluded that there is a high proportion of maxillary sinuses where AAA describes a course close to the alveolar crest (≤15mm), which was classically considered a safe distance for SFE. This position is related to the presence of atrophic crests (depressed ridge form) and wide maxillary sinuses where the distance of the vessel to the floor of the sinus is small. This information may permit a better surgical planning of SFE procedures.

Bibliographic References

  • Chiapasco, M, Casentini, P, Zaniboni, M. (2009). Bone augmentation procedures in implant dentistry. Int J Oral Maxillofac Implants. 24. 237
  • Maridati, P, Stoffella, E, Speroni, S, Cicciu, M, Maiorana, C. (2014). Alveolar antral artery isolation during sinus lift procedure with the double window technique. Open Dent J. 30. 95-103
  • Varela-Centelles, P, Loira-Gago, M, Seoane-Romero, JM, Takkouche, B, Monteiro, L, Seoane, J. (2015). Detection of the posterior superior alveolar artery in the lateral sinus wall using computed tomography/cone beam computed tomography: a prevalence meta-analysis study and systematic review. Int J Oral Maxillofac Surg. 44. 1405
  • Rodella, LF, Labanca, M, Boninsegna, R, Favero, G, Tschabitscher, M, Rezzani, R. (2010). Intraosseous anastomosis in the maxillary sinus. Minerva Stomatol. 59. 349
  • Valente, NA. (2016). Anatomical Considerations on the Alveolar Antral Artery as Related to the Sinus Augmentation Surgical Procedure. Clin Implant Dent Relat Res. 18. 1042
  • Wallace, SS, Tarnow, DP, Froum, SJ, Cho, SC, Zadeh, HH, Stoupel, J. (2012). Maxillary sinus elevation by lateral window approach: evolution of technology and technique. J Evid Based Dent Pract. 123. 161
  • Rahpeyma, A, Khajehahmadi, S. (2015). Open Sinus Lift Surgery and the Importance of Preoperative Cone-Beam Computed Tomography Scan: A Review. J Int Oral Health. 7. 127
  • Cone beam computed tomography investigation about the antral artery anastomosis in a center of Italy population.. Folia Morphol (Warsz).
  • Kang, SJ, Shin, SI, Herr, Y, Kwon, YH, Kim, GT, Chung, JH. (2013). Anatomical structures in the maxillary sinus related to lateral sinus elevation: a cone beam computed tomographic analysis. Clin Oral Implants Res. 24. 75-81
  • Ella, B, Sédarat, C, Noble Rda, C, Normand, E, Lauverjat, Y, Siberchicot, F. (2008). Vascular connections of the lateral wall of the sinus: surgical effect in sinus augmentation. Int J Oral Maxillofac Implants. 23. 1047
  • Cawood, JI, Howell, RA. (1988). A classification of the edentulous jaws. Int J Oral Maxillofac Surg. 17. 232
  • Chan, HL, Wang, HL. (2011). Sinus pathology and anatomy in relation to complications in lateral window sinus augmentation. Implant Dent. 20. 406
  • Flanagan, D. (2005). Arterial supply of maxillary sinus and potential for bleeding complication during lateral approach sinus elevation. Implant Dent. 14. 336
  • Jensen, SS, Eriksen, J, Schiodt, M. (2012). Severe bleeding after sinus floor elevation using the transcrestal technique: a case report. Eur J Oral Implantol. 5. 287
  • Mardinguer, O, Abba, M, Hirshberg, A, Schwartz-Arad, D. (2007). Prevalence, diameter and course of the maxillary intraosseous vascular canal with relation to sinus augmentation procedure: a radiographic study. Int Oral Maxillofac Surg. 36. 735
  • Ilgüy, D, Ilgüy, M, Dolekoglu, S, Fisekcioglu, E. (2013). Evaluation of the posterior superior alveolar artery and the maxillary sinus with CBCT. Braz Oral Res. 27. 431
  • Güncu, GN, Yildirim, YD, Wang, HL, Tözüm, TF. (2011). Location of posterior superior alveolar artery and evaluation of maxillary sinus anatomy with computerized tomography: a clinical study. Clin Oral Implants Res. 22. 1164
  • Jung, J, Yim, JH, Kwon, YD, Al-Nawas, B, Kim, GT, Choi, BJ. (2011). A radiographic study of the position and prevalence of the maxillary arterial endosseous anastomosis using cone beam computed tomography. Int J Oral Maxillofac Implants. 26. 1273
  • Yang, SM, Kye, SB. (2014). Location of maxillary intraosseous vascular anastomosis base don the tooth position and height of the residual alveolar bone: computed tomographic analysis. J Periodontal Implants Sci. 44. 50
  • Rosano, G, Tascheri, S, Gaudy, JF, Weinstein, T, Del Fabro, M. (2011). Maxillary sinus vascular anatomy and its relation to sinus lift surgery. Clin Oral Implants Res. 227. 711
  • Elian, N, Wallace, S, Cho, SC, Jalbout, ZN, Froum, S. (2005). Distribution of the maxillary artery as it relates to sinus floor augmentation. Int J Oral Maxillofac Implants. 20. 784
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