Alveolar antral artery isolation during sinus lift procedure with the double window technique

Abstract

The sinus lift technique, introduced in 1976 by Tatum and subsequently described by Boyne in 1980, is nowadays considered a safe and reliable procedure for the rehabilitation of the atrophic upper posterior maxilla. The alveolar antral artery (AAA) is anastomoses between the posterior superior alveolar artery (PSAA) and the infraorbital artery (IOA) and may be present in the sinusal antrostomy. The haemorrhage of this vascular bundle represents the second intra-operatory complication in term of frequency during sinus lift procedure. Purpose of this study was to illustrate and describe a new technique allowing the AAA isolation during sinus lift procedure in cases in which the artery is clearly present inside the surgical area, detectable through CT scan exam. Presence, course and possible identification of the alveolar antral artery are also discussed, according to the studies present in the literature.

Keywords: Alveolar antral artery; sinus lift complications..

Fig. (1)

Bony window as described by Boyne 1. The dimension of the antrostomy are aproximally 10 mm x 20 mm.

Fig. (2)

AAA identification through CT scan, cross sections.

Fig. (3)

The AAA course is highlined on the lateral wall of the maxillary sinus using a surgical pencil.

Fig. (4)

Double window design. AAA course remains covered by a bony wall as a protection from possible damages.

Fig. (5)

Graft material in place surrounding the AAA course.

Fig. (6)

Implant insertion after 6 months. No complications were reported.

Fig. (7)

Perforation of the sinusal membrane is the intra-operative complication with the higher frequency.

Fig. (9)

(8 and 9). AAA course in two cases in which the double window technique hasn’t been used. As well seen, the artery is exposed and damages can easily occur.