Soundarajan Subasree, Kaarthikeyan Gurumoorthy
Department of Periodontics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences (SIMATS), Chennai, 600077, Tamil Nadu, India.
Oral Radiol. 2023 Jan;39(1):101-107. doi: 10.1007/s11282-022-00607-0. Epub 2022 Apr 30.
The posterior superior alveolar artery (PSAA) and the infraorbital artery (IOA), both of which are ultimate branches of the maxillary artery, are connected by a horizontal anastomosis. PSAA anastomoses intraosseously and extraosseously with IOA. Profuse bleeding from the lateral wall while performing the direct sinus augmentation is a significant intraoperative complication.Thus the present study focused to assess the location of an alveolar antral anastomosis (AAA) in relation to the crest of the alveolar bone using cone beam computed tomography (CBCT).
A total of 200 CBCT scans of patients who were indicated for implant surgery were chosen and assessed. Group 1 includes 100 dentate patients and Group 2 includes 100 partially edentulous patients. The location of anastomosis along the lateral wall of the maxillary sinus was evaluated in association with alveolar bone height with respect to three posterior maxillary teeth: first premolar, second premolar, and first molar.
The mean distance for P1, P2, and M1 was 21.94 ± 1.02 mm, 19.41 ± 0.40 mm, and 17.36 ± 0.51 mm, respectively, in the dentate group, whereas in the edentulous group, it was 20.07 ± 0.46 mm, 18.95 ± 0.32 mm, and 16.08 ± 0.16 mm. In 80% of participants, the distance of an AAA from the alveolar crest was between 16 and 23 mm, whereas in 12% of the participants the distance of an AAA from the alveolar crest was less than 16 mm.
The present study concludes that the first premolar region is safe for preparing the lateral window but for the second premolar and first molar additional care should be taken prior to surgery.
上牙槽后动脉（PSAA）和眶下动脉（IOA）均为上颌动脉的终末分支，二者通过水平吻合相连。PSAA在骨内和骨外与IOA吻合。在进行直接窦底增高术时，侧壁大量出血是一种严重的术中并发症。因此，本研究旨在使用锥形束计算机断层扫描（CBCT）评估牙槽窦吻合（AAA）相对于牙槽嵴的位置。
选取200例拟行种植手术患者的CBCT扫描图像进行评估。第1组包括100例有牙患者，第2组包括100例部分牙列缺失患者。结合上颌后三颗牙齿（第一前磨牙、第二前磨牙和第一磨牙）的牙槽骨高度，评估上颌窦侧壁吻合的位置。
在有牙组中，P1、P2和M1的平均距离分别为21.94±1.02mm、19.41±0.40mm和17.36±0.51mm，而在无牙组中，分别为20.07±0.46mm、18.95±0.32mm和16.08±0.16mm。在80%的参与者中，AAA距牙槽嵴的距离在16至23mm之间，而在12%的参与者中，AAA距牙槽嵴的距离小于16mm。
本研究得出结论，第一前磨牙区域制备侧窗是安全的，但对于第二前磨牙和第一磨牙，手术前应格外小心。
