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CBCT-based retrospective analysis of posterior superior alveolar artery anatomy in a Saudi population

anatomy-and-physiology
dentistry
evidence-based-medicine
radiology-and-medical-imaging
surgery-and-surgical-specialties

Abstract

Background. Sinus elevation procedures in the posterior maxilla often present challenges, particularly the risk of hemorrhage due to injury to the posterior superior alveolar artery (PSAA). Preoperative identification of PSAA anatomy using cone-beam computed tomography (CBCT) can help prevent such complications and improve surgical safety.

Methods. This retrospective study aimed to evaluate the prevalence, location, diameter, and visibility of the PSAA in a Saudi Arabian population using CBCT imaging. A cross-sectional analysis was conducted using 117 CBCT scans (234 sinuses) obtained at Taibah University Dental Hospital. Anatomical parameters of the PSAA were measured, including vertical and horizontal distances from sinus landmarks, artery diameter, and anatomical location. Associations with age, gender, smoking status, and presence of sinus septa were also analyzed.

Results. The PSAA was detected in 98.3% of sinuses. Intraosseous and submucosal locations were most common in the premolar and molar regions, respectively. Class A arteries (≤1 mm diameter) were the most frequent. Statistically significant differences were observed between premolar and molar regions in arterial location and distances from the alveolar crest and sinus walls (p < 0.001). Age was associated with medial displacement of the artery in the molar region. Smokers had significantly smaller artery diameters. The presence of sinus septa was associated with increased PSAA distance from the sinus floor and medial wall.

Conclusions. The PSAA exhibits high anatomical variability in location and dimension, with region-specific patterns. Preoperative CBCT assessment is essential for minimizing intraoperative vascular complications during sinus augmentation procedures.

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