A Radiographic Study of the Position and Prevalence of the Maxillary Arterial Endosseous Anastomosis Using Cone Beam Computed Tomography

Purpose: This study was designed to investigate the prevalence and course of the vascular canals in the maxillary sinus walls and to measure the distance between the sinus floor, the edentulous alveolar crest, and the vascular canal using cone beam computed tomography (CBCT). Materials and Methods: The maxillary sinus CBCT scans of 250 patients scheduled for implant surgery were examined. The vertical and mediolateral positions of the vascular canals or notches were investigated on the CBCT images. The location of each tooth was confirmed using a diagnostic template for implant placement. Statistical analyses were performed to verify whether the mean artery position was significantly different according to each tooth location, gender, and age. Results: A maxillary arterial endosseous anastomosis was observed in 52.8% of patients. The mean perpendicular distance from the sinus floor to the vascular canal was shortest in the first molar region (7.58 ± 3.19 mm) and longest in the first premolar region (9.2 ± 3.22 mm). The mean distance from the alveolar crest to the vascular canal was shortest in the first molar region (14.79 ± 4.04 mm) and longest in the first premolar region (18.92 ± 4.86 mm). These distances were significantly different according to tooth position. The mean distances from the alveolar crest and the sinus floor to the vascular canal did not decrease with age. The mediolateral position of the canals was also significantly different depending on tooth position. Conclusion: With this information about the branch of the posterior superior alveolar artery from CBCT, unnecessary bleeding during implant placement should be more easily preventable. The use of CBCT is recommended as a routine procedure prior to sinus floor elevation. Keywords: cone beam computed tomography, maxillary artery, maxillary sinus, sinus elevation