Clinical research

Cone-beam CT analysis of anatomical structure of maxillary sinus arteries

  • Jiongrui WU ,
  • Yiming GAO
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  • 1.Department of Stomatology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
    2.Shanghai Jiao Tong University School of Stomatology, Shanghai 200125, China
GAO Yiming, E-mail: drgaoym@163.com.

Received date: 2022-09-19

  Accepted date: 2023-02-13

  Online published: 2023-02-28

Abstract

Objective ·To analyze the anatomical structural characteristics of maxillary sinus artery (MSA) by cone-beam CT (CBCT) measurement. Methods ·The MSAs in the bilateral maxillary sinuses were observed in 1 021 patients who went to Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, for implant surgery due to dentition defect or loss. In the CBCT bone window view, the position between the MSA foramen and the bone wall at the midline of the second premolar (P2), the first molar (M1), and the second molar (M2) was measured, and the intrasinus (the artery was located below the mucosa of maxillary sinus), intraosseous (the artery was completely located in the lateral wall of maxillary sinus), and superficial (the artery was located below the periost of the lateral wall of maxillary sinus) types of their location were classified. The distance between the upper and lower edges of the MSA foramen was measured as the diameter of the artery (DMSA). The distance between the lower margin of the vessel and the sinus floor (DVSF) was measured. The lateral wall thickness of maxillary sinus and the width of maxillary sinus at 5 mm above the maxillary sinus floor at the middle line of the M1 tooth position were measured, and the angle formed by the internal and external side walls of maxillary sinus at 10 mm above the lowest point of maxillary sinus floor was measured. The differences of variability of MSA position, MSA shape type, DMSA and DVSF in patients of different genders and ages were statistically analyzed. At the same time, the correlation between DMSA and DVSF of MSA and the lateral wall thickness, width and angle of maxillary sinus were statistically analyzed. Results ·① Variability of MSA position: In the 1 021 patients, 42 patients (4.1%) had MSA located at the lateral wall of the maxillary sinus and close to the maxillary sinus floor, of which 14 patients (33.3%) had bilateral MSA, and 28 patients (66.7%) had unilateral MSA. Seven patients (0.7%) had MSA located in the alveolar bone below the maxillary sinus floor, of which 1 case (14.3%) had MSA located in the alveolar bone bilaterally, and 6 cases (85.7%) had MSA located in the alveolar bone unilaterally. ② MSA shape type: The intrasinus type accounted for 36.5%, the intraosseous type accounted for 60.4%, and the superficial type accounted for 3.1%. The proportion of intraosseous type in middle-aged patients (63.0%) was higher than that in young and elderly patients (P=0.005). ③ DMSA: DMSA was the largest in M1 tooth position, which was (1.42±0.44) mm. The DMSAs of males in P2, M1 and M2 tooth position were bigger than those of females. There was a weak positive correlation between the lateral wall thickness of maxillary sinus and DMSA in P2 and M1 tooth position (r =0.2, r =0.2). In M1 tooth position, the width and angle of maxillary sinus were weakly negatively correlated with DMSA (r =-0.1, r =-0.2). ④DVSF: DVSF decreased gradually from M2 to P2. The DVSFs of males in P2 and M2 tooth position were larger than those of females. There was a weak negative correlation between the lateral wall thickness of maxillary sinus and DVSF in M1 tooth position (r =-0.3). There was a weak negative correlation between the width of maxillary sinus and DVSF in M1 position (r =-0.1). Conclusion ·The position of MSA may vary in the alveolar bone at the maxillary sinus floor and at the alveolar bone. With the increasing of age, the shape type of MSA changes from intrasinus type to intraosseous type.Male patients have greater DMSA and greater risk of arterial bleeding than women. The larger DMSA can be observed in the thicker lateral wall of maxillary sinus, while the DMSA is smaller when the width and angle of maxillary sinus is larger. The DVSF in men is larger than that in women, and the DVSF is smaller in the thicker lateral wall of maxillary sinus or when the width of maxillary sinus is larger.

Cite this article

Jiongrui WU , Yiming GAO . Cone-beam CT analysis of anatomical structure of maxillary sinus arteries[J]. Journal of Shanghai Jiao Tong University (Medical Science), 2023 , 43(2) : 201 -207 . DOI: 10.3969/j.issn.1674-8115.2023.02.009

References

1 TOSCANO N J, HOLTZCLAW D, ROSEN P S. The effect of piezoelectric use on open sinus lift perforation: a retrospective evaluation of 56 consecutively treated cases from private practices[J]. J Periodontol, 2010, 81(1): 167-171.
2 CHITSAZI M T, SHIRMOHAMMADI A, FARAMARZI M, et al. Evaluation of the position of the posterior superior alveolar artery in relation to the maxillary sinus using the cone-beam computed tomography scans[J]. J Clin Exp Dent, 2017, 9(3): e394-e399.
3 李濠吉, 刘敏. 锥形束CT评估上颌窦侧壁开窗术术中出血风险[J]. 口腔医学研究, 2017, 33(10): 1099-1102.
3 LI H J, LIU M. Evaluation of bleeding risk in maxillary sinus lateral wall fenestration based on cone beam CT[J]. Journal of Oral Science Research, 2017, 33(10): 1099-1102.
4 MONJE A, CATENA A, MONJE F, et al. Maxillary sinus lateral wall thickness and morphologic patterns in the atrophic posterior maxilla[J]. J Periodontol, 2014, 85(5): 676-682.
5 YANG S M, KYE S B. Location of maxillary intraosseous vascular anastomosis based on the tooth position and height of the residual alveolar bone: computed tomographic analysis[J]. J Periodontal Implant Sci, 2014, 44(2): 50-56.
6 KALYVAS D, KAPSALAS A, PAIKOU S, et al. Thickness of the Schneiderian membrane and its correlation with anatomical structures and demographic parameters using CBCT tomography: a retrospective study[J]. Int J Implant Dent, 2018, 4(1): 32.
7 TOURBAH B, MAAREK H. Complications of maxillary sinus bone augmentation: prevention and management[M]//Sinus grafting techniques. Cham: Springer International Publishing, 2014: 195-233.
8 MARDINGER O, ABBA M, HIRSHBERG A, et al. Prevalence, diameter and course of the maxillary intraosseous vascular canal with relation to sinus augmentation procedure: a radiographic study[J]. Int J Oral Maxillofac Surg, 2007, 36(8): 735-738.
9 VARELA-CENTELLES P, LOIRA-GAGO M, SEOANE-ROMERO J M, et al. 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[J]. Int J Oral Maxillofac Surg, 2015, 44(11): 1405-1410.
10 ELLA B, SéDARAT C, DAC NOBLE R, et al. Vascular connections of the lateral wall of the sinus: surgical effect in sinus augmentation[J]. Int J Oral Maxillofac Implants, 2008, 23(6): 1047-1052.
11 VALENTE N A. Anatomical considerations on the alveolar antral artery as related to the sinus augmentation surgical procedure[J]. Clin Implant Dent Relat Res, 2016, 18(5): 1042-1050.
12 李娜, 王虎, 任家银, 等. 上颌窦提升术中上颌窦解剖生理及病理的CBCT探讨[J]. 中国口腔种植学杂志, 2012, 17(3): 101-105, 128.
12 LI N, WANG H, REN J Y, et al. Role of cone-beam CT on anatomic physiological and pathological maxillary sinus for sinus floor elevation [J]. Chinese Journal of Oral Implantology, 2012, 17(3): 101-105, 128.
13 ILGüY D, ILGüY M, DOLEKOGLU S, et al. Evaluation of the posterior superior alveolar artery and the maxillary sinus with CBCT[J]. Braz Oral Res, 2013, 27(5): 431-437.
14 YALCIN E D, AKYOL S. Relationship between the posterior superior alveolar artery and maxillary sinus pathology: a cone-beam computed tomography study[J]. J Oral Maxillofac Surg, 2019, 77(12): 2494-2502.
15 DANESH-SANI S A, MOVAHED A, ELCHAAR E S, et al. Radiographic evaluation of maxillary sinus lateral wall and posterior superior alveolar artery anatomy: a cone-beam computed tomographic study[J]. Clin Implant Dent Relat Res, 2017, 19(1): 151-160.
16 VALENTE N A. Anatomical considerations on the alveolar antral artery as related to the sinus augmentation surgical procedure[J]. Clin Implant Dent Relat Res, 2016, 18(5): 1042-1050.
17 WATANABE T, SHIOTA M, GAO S, et al. Verification of posterior superior alveolar artery distribution in lateral wall of maxillary sinus by location and defect pattern[J]. Quintessence Int, 2014, 45(8): 673-678.
18 MARIDATI P, STOFFELLA E, SPERONI S, et al. Alveolar antral artery isolation during sinus lift procedure with the double window technique[J]. Open Dent J, 2014, 8: 95-103.
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