Anastamosis of PSA Artery - Infraorbital Artery And Sinus Augmentation

Purpose: The purpose of this study was to characterize the prevalence, diameter and course of the intraosseous anastomosis between the PSAA and the IOA (the bony canal), involved in the procedure of sinus floor augmentation. Material and methods: Data from 208 sinuses were analyzed from reconstructed CT images. The CT images were examined for the presence of the intraosseous anastomosis in the lateral antral wall using suggital plane sections Parameters examined:, The intraosseous course (distance from the alveolar ridge) and diameter of the bony canal. Results: The bony canal was identified in 114 of 208 maxillary sinuses (54.8%).. The course of the bony canal forms an arcade. The mean distance from the alveolar ridge was 16.9 mm. From the examined canals, 6.7% identified as 2 – 3 mm width, 22.1% identified as 1-2 mm width, and 26% was less than 1mm. Discussion: There is a high probability of transecting the bony canal vessel while preparing the bony lateral window during sinus augmentation procedure thus injuring the blood supply to the bone and graft, The course and size of the anastemosis in the lateral bone of the maxillary sinus, also might play a roll as a surgical bleeding obstacle.. Conclusions: Considering the bony course of the canal, we recommend placing the superior border of the osteotomy (in the lateral wall technique of sinus augmentation procedure) as far as 16 mm from the alveolar crest to minimize the possibility of bleeding and harming the local blood supply. Dental scan CT is recommended as a part of pre-surgical diagnosis and treatment planning.