Editorial Type:
Article Category: Research Article
 | 
Online Publication Date: 21 Apr 2022

Prevalence of the Alveolar Antral Artery and Its Accessory Arteries in Cone-Beam Computed Tomography Scans

DDS,
BDS, PhD,
DDS,
DDS, and
DDS, PhD
Page Range: 391 – 398
DOI: 10.1563/aaid-joi-D-20-00307
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Alveolar antral artery (AAA) damage can cause perioperative hemorrhage during osteotomy. The aim of this study was to assess the prevalence of AAA presence and evaluate its characteristics using cone-beam computerized tomography (CBCT). One hundred maxillary sinuses were evaluated from 70 CBCT scans. The anteroposterior dimension of each sinus was divided into four equal quarters, and the main artery presence was noted for each section. Arterial diameter as well as distance to sinus floor and to alveolar ridge were measured, and the position of the main artery according to its location relative to the lateral sinus wall was determined. In cases where additional arteries were detected, their diameter and position were also determined. Artery prevalence was 87.0%. In 42% and 8% of the cases respectively, a second and third artery were visualized. No significant association was found between the prevalence of the arteries and age of participants. However, the prevalence of a secondary artery among men (56.4%) was significantly higher than in women (32.8%) (P = .02). Moreover, the main artery diameter was significantly different between sections (P = .014), as was its position. AAA was radiographically detectable in the majority of studied sinuses. In 2 cases, 3 arteries were visible. Arteries with a diameter ≥ 2 mm were not frequent. However, arteries exceeding this diameter must be factored in when choosing surgical techniques. The findings of this study suggest there might be accessory arteries associated with AAA. Therefore, preoperative radiological CBCT examination is necessary prior to any sinus floor elevation surgery.

Figure 1.
Figure 1.

Schematic representation of the left maxilla, lateral view, with blood vessels.


Figure 2.
Figure 2.

Radiographic measurement. (a) Division of the sinuses. (b) Measurements done for each visible artery on the coronal sections. M indicates anterior limit of the sinus (mesial); D, posterior limit of the sinus (distal); Ant, anterior section; Mid, middle section; Pos, posterior section; d, diameter of the artery; s.f., sinus floor; c.r., crestal ridge.


Figure 3.
Figure 3.

Different positions of the AAA on the lateral bony wall of the sinus. (a) external (E); (b) completely embedded in the lateral wall; (c) internal (I); (d) from side to side (EI). Circle indicates the position of the artery.


Figure 4.
Figure 4.

Coronal (a) and sagittal (b) sections of CBCT showing the main artery and a secondary artery. Coronal (c) and sagittal (d) sections of CBCT of another patient showing the main artery, a secondary, and a tertiary artery. Circle/arrow indicates the position of the artery.


Figure 5.
Figure 5.

Position of the main artery at the different sections.


Contributor Notes

Corresponding author, e-mail: Christian.makery@usj.edu.lb
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