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Presurgical CBCT assessment of maxillary neurovascularization in relation to maxillary sinus augmentation procedures and posterior implant placement

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Abstract

Purpose

To provide more information to clinicians planning sinus grafting and maxillofacial surgical interventions, the present study evaluated the prevalence, diameter and location of the superior alveolar canals (SAC) using CBCT images.

Methods

The maxillary sinus CBCT scans (i-CAT Classic®, ISI, USA) of 100 adult patients (67 women and 33 men) aged 20–79 years [mean (SD) 40 (15)] were examined. A dentomaxillofacial radiologist observed the SAC based on CBCT image data and more specifically the parasagittal views to assess SAC’s diameter and location.

Results

The anterior and posterior SAC, double ASAC, intraosseous anastomoses and the extension of the anterior SAC to the piriform aperture were observed in 100, 73, 24.5, 38.5 and 84 % of the cases, respectively. The anastomosis was located between canine and first premolar in 43 % of the cases. The SAC diameters were in 80 % of the cases ≤1 mm, remaining canals had a diameter between 1 and 2 mm. The distance of the SAC to the alveolar crest ranged between 2.42 and 44.6 mm. The anterior SAC was more prevalent in the upper (53 %) and middle (44 %) thirds of the maxillary sinus, while the posterior SAC was more prevalent in the middle (36 %) and lower thirds (64 %). The distance was significantly bigger in men in some tooth positions.

Conclusions

Based on the present findings, one-fifth of the patients may have a diameter of the SAC >1 mm, large enough to cause bleeding and/or paraesthesia. CBCT imaging may assist surgeons to plan grafting and osteotomy procedures, while avoiding these neurovascular structures.

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Conflict of interest

This study was supported by a grant and fellowship from FAPESP (State of São Paulo Research Foundation).

Ethical standards

This study was approved by the Bauru School of Dentistry—University of Sao Paulo Ethics Committee (No. 124/2011).

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Authors and Affiliations

  1. OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, University of Leuven and Oral and Maxillofacial Surgery, University Hospitals Leuven, Campus Sint-Rafaël, Kapucijnenvoer 33, 3000, Leuven, Belgium

    Laura Ferreira Pinheiro Nicolielo, Jeroen Van Dessel & Reinhilde Jacobs

  2. Department of Morphology, Faculty of Medicine, University of Hasselt, Campus Diepenbeek, Agoralaan gebouw D, 3590, Diepenbeek, Belgium

    Wendy Martens & Ivo Lambrichts

  3. Department of Stomatology, Bauru School of Dentistry, University of Sao Paulo, Al. Octávio Pinheiro Brisola 9-75, 17012-901, Bauru, Sao Paulo, Brazil

    Laura Ferreira Pinheiro Nicolielo & Izabel Regina Fischer Rubira-Bullen

Authors
  1. Laura Ferreira Pinheiro Nicolielo
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  2. Jeroen Van Dessel
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  3. Reinhilde Jacobs
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  4. Wendy Martens
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  5. Ivo Lambrichts
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  6. Izabel Regina Fischer Rubira-Bullen
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Correspondence to Laura Ferreira Pinheiro Nicolielo.

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Nicolielo, L.F.P., Van Dessel, J., Jacobs, R. et al. Presurgical CBCT assessment of maxillary neurovascularization in relation to maxillary sinus augmentation procedures and posterior implant placement. Surg Radiol Anat 36, 915–924 (2014). https://doi.org/10.1007/s00276-014-1309-3

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  • DOI: https://doi.org/10.1007/s00276-014-1309-3

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