Presurgical CBCT assessment of maxillary neurovascularization in relation to maxillary sinus augmentation procedures and posterior implant placement.
OBJECTIVE
To provide more information to clinicians planning sinus grafting and maxillofacial surgical interventions, the present study evaluated the prevalence, diameter and location of the superior alveolar canals (SAC) using CBCT images.


METHODS
The maxillary sinus CBCT scans (i-CAT Classic(®), ISI, USA) of 100 adult patients (67 women and 33 men) aged 20-79 years [mean (SD) 40 (15)] were examined. A dentomaxillofacial radiologist observed the SAC based on CBCT image data and more specifically the parasagittal views to assess SAC's diameter and location.


RESULTS
The anterior and posterior SAC, double ASAC, intraosseous anastomoses and the extension of the anterior SAC to the piriform aperture were observed in 100, 73, 24.5, 38.5 and 84 % of the cases, respectively. The anastomosis was located between canine and first premolar in 43 % of the cases. The SAC diameters were in 80 % of the cases ≤1 mm, remaining canals had a diameter between 1 and 2 mm. The distance of the SAC to the alveolar crest ranged between 2.42 and 44.6 mm. The anterior SAC was more prevalent in the upper (53 %) and middle (44 %) thirds of the maxillary sinus, while the posterior SAC was more prevalent in the middle (36 %) and lower thirds (64 %). The distance was significantly bigger in men in some tooth positions.


CONCLUSIONS
Based on the present findings, one-fifth of the patients may have a diameter of the SAC >1 mm, large enough to cause bleeding and/or paraesthesia. CBCT imaging may assist surgeons to plan grafting and osteotomy procedures, while avoiding these neurovascular structures.
OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, University of Leuven and Oral and Maxillofacial Surgery, University Hospitals Leuven, Campus Sint-Rafaël, Kapucijnenvoer 33, 3000, Leuven, Belgium, lauranicolielo@yahoo.com.br.
Laura Ferreira Pinheiro
LF
Nicolielo
Jeroen
J
Van Dessel
Reinhilde
R
Jacobs
Wendy
W
Martens
Ivo
I
Lambrichts
Izabel Regina Fischer
IR
Rubira-Bullen
D000328:Adult; D000368:Aged; D054893:Cone-Beam Computed Tomography; D015921:Dental Implants; D005260:Female; D006801:Humans; D008297:Male; D008443:Maxillary Sinus / Q000098:blood supply* / Q000000981:diagnostic imaging*; D008875:Middle Aged; D010347:Patient Care Planning; D011300:Preoperative Care / Q000379:methods*; D059546:Sinus Floor Augmentation; D055815:Young Adult
D015921:Dental Implants