| Objective:To investigate the detection and location of the posterior superior alveolar artery under different gender,age and tooth loss conditions by cone-beam computed tomography,and analyze its correlation,so as to provide support for avoiding intraoperative bleeding in maxillary sinus elevation surgery.Methods:A total of 300 patients(600 maxillary sinuses in total)who met the requirements were selected and divided into normal group and missing group according to whether the maxillary molars were missed.Researchers observed the bone foramen of the posterior maxillary artery seen for the first time and the last time on the lateral wall of the maxillary sinus using a cone-beam computed tomography coronal image and recorded the detection of rate the artery and its course on the lateral wall of the maxillary sinus.The diameter of the foramen,the horizontal distance from the lower edge of the foramen to the medial wall of the upper alveolar,the vertical distance from the lower edge of the foramen to the crest of the alveolar ridge,and the vertical distance from the lower edge of the foramen to the bottom of the maxillary sinus were measured.Results:1.The posterior superior alveolar artery could be detected in 88.8% of the maxillary sinus,among which the intraosseous type was the most common(67.2%),beneath the sinus membrane type was the second(28.5%),and on the external cortex of the lateral sinus wall type was the least(4.3%).The detection rate of the posterior superior alveolar artery was not related to gender(P>0.05),but affected by age(P<0.05).2.The diameter of PSAA in the lateral wall of the maxillary sinus gradually decreased from posterior to anterior.The average diameter of the normal group was 0.993±0.239 mm,and that of the edentulous group was 1.021±0.228 mm.In the normal group,the diameter of the posterior superior alveolar artery in male population was significantly larger than that in female population and increased with age(P<0.05).The diameter of the posterior superior alveolar artery in the missing teeth group was not correlated with gender(P>0.05).3.In the normal group,the horizontal distances from the lower margin of the posterior superior alveolar artery foramen to the medial wall of the maxillary sinus were12.576±2.543 mm.The vertical distance from the lower margin of the foramen to the floor of the maxillary sinus were 8.674±2.862 mm.And the vertical distance from the lower margin of the foramen to the crest of the alveolar ridge were 19.883±3.061 mm.Above distances were 12.809±2.295 mm,8.684±2.731 mm and 15.975±2.958 mm in the missing teeth group.In the normal group,the distance from the lower margin of the final bone foramen to the medial wall and floor of the maxillary sinus was higher in males than in female population,and decreased with age(P<0.05).In the missing teeth group,there was no relationship between sex and measurement(P>0.05).However,the distance from the lower margin of the bone foramen to the sinus floor and alveolar ridge was related to age(P<0.05),and the minimum distance was 14.921±2.582 mm in the age group of 51-65 years.The diameter of the posterior superior alveolar artery and its distance to the floor of the maxillary sinus did not change with the loss of the tooth(P>0.05).The distance between the lower edge of the bone foramen and the alveolar crest decreases(P<0.05).Conclusion:1.PSAA was present in all patients,but its detection rate on CBCT was 88.8%,and it was more likely to be observed in older patients.2.After tooth loss,the distance between the posterior alveolar artery and the alveolar crest decreases with age,and the distance is shortest in the age group of 51-65 years.In order to avoid damage on posterior superior alveolar artery,the height of the window should be less than 15 mm during lateral sinus floor elevation.3.The distance from the posterior superior alveolar artery to the sinus floor was not affected by the factor of tooth loss.The antral floor of the maxillary sinuses can be used as a stable anatomic reference. |
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