Blood supply to the maxillary sinus relevant to sinus floor elevation procedures

Area of Science:

• Oral and Maxillofacial Surgery
• Anatomy
• Vascular Biology

Background:

• Maxillary blood supply is critical for bone vitality, graft integration, and healing after procedures like sinus floor elevation.
• Edentulous maxillae exhibit reduced vascularity with bone resorption, but specific vascular conditions for sinus floor elevation remain understudied.

Purpose of the Study:

• To investigate the vascularization of the lateral maxilla in the context of tooth loss.
• To examine the maxillary arteries relevant to sinus floor elevation surgery.

Main Methods:

• Anatomical preparation of maxillary arteries in 18 human specimens (10 male, 8 female, mean age 67).
• Recording of main arteries, branches, anastomoses, calibers, and distances to the alveolar ridge.
• Analysis of intraosseous and extraosseous anastomoses between the posterior superior alveolar artery (PSAA) and infraorbital artery (IOA).

Main Results:

• An intraosseous anastomosis between PSAA and IOA was consistently found, supplying the lateral antral wall and Schneiderian membrane.
• An extraosseous anastomosis was present in 8 of 18 specimens, forming a double arterial arcade.
• PSAA and IOA had a mean caliber of 1.6 mm, with specific numbers of endosseous and extraosseous branches noted.
• The intraosseous anastomosis was located at a mean distance of 19 mm from the alveolar ridge.

Conclusions:

• The lateral maxilla is supplied by a dual arterial arcade formed by the PSAA and IOA.
• This robust vascularization maintains periosteal blood supply to the lateral antral wall, even in severe maxillary atrophy.
• Understanding this vascular anatomy is crucial for successful sinus floor elevation procedures.