Prevention of inadvertent intra-operative trauma to alveolar antral artery utilizing Cone Beam Computed Tomography analysis

Abstract

Introduction: Inadvertent injury to the alveolar antral artery during any surgical procedure involving the maxillary sinus can cause profuse bleeding. Literature reveals that there is a significant discrepancy in the course of this artery across various populations. During pre-surgical planning, Cone Beam Computed Tomography (CBCT) is utilized to prevent any unintended injury to the antral artery during implant placement.

Objective: To disclose the path of the alveolar antral artery utilizing CBCT in patients presenting to a tertiary care dental hospital of Peshawar, Khyber Pakhtunkhwa.

Materials & Methods: A cross sectional descriptive study was conducted from April 01, 2021, to March 30, 2022, on retrospective data of 608 CBCT maxillary scans of dentate patients who presented to Rehman College of Dentistry, Peshawar, during the year 2020. All CBCT images were acquired using CS 9000 (Care stream Dental, Atlanta, GA) with power requirements of 220V/20A and a 3D field of view of 5*3.75 cm. The average distance of the alveolar antral artery from all four maxillary teeth in the posterior region was calculated. Data were analysed for descriptive statistics through statistical software SPSS 22.

Results: Out of 608 posterior maxillary areas examined the antral artery was detected in 442 (72.9%) areas. The average distance of antral artery from the posterior teeth in first and second quadrant was calculated to be 19.58 ± 5.69 mm.

Conclusion: Cone beam computed tomogram, in a presurgical planning phase, emerged as an essential and inevitable tool for analysing the presence and course of alveolar antral artery and its variations to minimise injury to the artery and its associated complications.