Important anatomical variations of the superior posterior alveolar artery: Studied by cone beam computed tomography

The knowledge of anatomical variations of the posterior superior alveolar artery (PSAA) is very important in surgeries for maxillary sinus (MS) elevation and subsequent insertion of dental implants, avoiding common and serious surgical complications. The main objective of this study was to analyse important anatomical variations of the PSAA by means of cone beam computed tomography (CBCT) examinations. 180 tomographic CBCT were analysed, and MS was divided into three equal regions: (I) anterior, (II) intermediate and (III) posterior. Variables evaluated were the visualisation of the artery, distance from the artery to the ridge crest, distance from the artery to the sinus floor, alveolar ridge height and arterial diameter. The PSAA visualisation was more prevalent in males and region III (76.7%). The distance from the artery to the sinus floor presented no significant difference between regions II and III, with both regions showing significantly lower values than region I. A significant difference was observed in the diameter of the arteries with higher prevalence of diameters >1.0 mm in males and <1.0 mm in females. The PSAA can be well visualised frequently with a CBCT, and differences in artery diameter were observed in relation to gender (males > females). Additional care is recommended when it is necessary to extend surgeries to the posterior MS region, avoiding haemorrhages that are associated with failures in these procedures.