Distribution of the maxillary artery as it relates to sinus floor augmentation

Knowledge of the blood supply to the sinus is of importance in sinus augmentation, both as it pertains to vascularization of the sinus graft and as its location relates to the position of the required lateral osteotomy. The purpose of this study was to investigate the distribution of the endosseous branches of the maxillary artery in the area of the proposed lateral window.

Fifty computerized tomographic (CT) scans from 625 available patients undergoing sinus augmentation surgery at the New York University Department of Implant Dentistry were chosen at random for evaluation. In those cases where the maxillary artery could be identified, measurements were taken to determine the distance between the alveolar crest and the lower border of the vessel.

The vessel was radiographically identified in 51.4% of right sinuses and 54.3% of left sinuses in the 50 CT scans. The average height of the artery from the alveolar crest was 16 mm (+/- 3.5 mm).

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Because of its location, the intraosseous artery has the potential to cause bleeding complications in approximately 20% of normally positioned lateral window osteotomies. Although a previous anatomic study on cadavers identified the vessel in 100% of the specimens, it could only be visualized in 53% of the CT scans in the present series.