Department of Periodontology, Faculty of Dentistry, Hacettepe University, Ankara, TurkeyDepartment of Periodontics and Oral Medicine, School of Dentistry, The University of Michigan, Ann Arbor, MI, USA.
Clin Oral Implants Res. 2011 Oct;22(10):1164-1167. doi: 10.1111/j.1600-0501.2010.02071.x. Epub 2011 Jan 18.
Knowledge and evaluation of the maxillary sinus anatomy before sinus augmentation are essential for avoiding surgical complications. Posterior superior alveolar artery (PSAA) is the branch of maxillary artery that supplies lateral sinus wall and overlying membrane. The aims of this study were to examine the prevalence, diameter, and location of the PSAA and its relationship to the alveolar ridge and to study the prevalence of the sinus pathology and septum using computerized tomography (CT) scans.
One hundred and twenty-one CT scans (242 sinuses) from patients undergoing sinus augmentation procedure and/or implant therapy were included. Lower border of the artery to the alveolar crest, bone height below the sinus floor to the ridge crest, distance of the artery to the medial sinus wall, diameter of the artery, and position of the artery were measured; presence of septa and pathology were recorded from CT sections.
Prevalence of sinus septa and sinus pathology was 16.1% and 24.8%, respectively. Artery was seen in 64.5% of all sinuses and was mostly intraosseous (68.2%). Mean diameter of PSAA was found 1.3 ± 0.5 mm. No significant correlation between the diameter of the artery and age was observed.
The results from this study suggested that CT scan is a valuable tool in evaluating presence of sinus pathology, septa, and arteries before maxillary sinus surgery. Although variations exist in every patient, the findings from this study suggest limiting the superior border of the lateral window up to 18 mm from the ridge to avoid any potential vascular damage.
在鼻窦提升术前了解上颌窦解剖结构至关重要,可避免手术并发症。上颌后牙槽动脉(PSAA)是供应上颌窦外侧壁和覆盖膜的分支。本研究旨在检查 PSAA 的发生率、直径和位置及其与牙槽嵴的关系,并通过计算机断层扫描(CT)研究窦腔病理和中隔的发生率。
本研究纳入了 121 例接受鼻窦提升术和/或种植治疗的患者的 242 个鼻窦 CT 扫描图像。测量了动脉下缘至牙槽嵴、窦底至牙槽嵴顶的骨高度、动脉至内侧窦壁的距离、动脉直径以及动脉位置;从 CT 切片中记录中隔和窦腔病理的存在情况。
窦中隔和窦腔病理的发生率分别为 16.1%和 24.8%。64.5%的窦腔中可见动脉,且多位于骨内(68.2%)。PSAA 的平均直径为 1.3±0.5mm。未观察到动脉直径与年龄之间存在显著相关性。
本研究结果表明,CT 扫描是评估上颌窦手术前窦腔病理、中隔和动脉的有价值工具。尽管每位患者都存在差异,但本研究的结果表明,为避免潜在的血管损伤,应将外侧窗的上缘限制在距牙槽嵴 18mm 以内。