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. 2023 Sep;53(3):177-191.
doi: 10.5624/isd.20230009. Epub 2023 Aug 2.

Anatomic evaluation of the posterior superior alveolar artery using cone-beam computed tomography: A systematic review and meta-analysis

Faraz Radmand  1 , Tahmineh Razi  2 , Milad Baseri  3 , Leili Faraji Gavgani  4   5 , Fatemeh Salehnia  5 , Masoumeh Faramarzi  6
Affiliations

Anatomic evaluation of the posterior superior alveolar artery using cone-beam computed tomography: A systematic review and meta-analysis

Faraz Radmand et al. Imaging Sci Dent. 2023 Sep.

Abstract

Purpose: This systematic review examined the detection of the posterior superior alveolar artery, along with various anatomic characteristics, on cone-beam computed tomography images.

Materials and methods: Studies were identified electronically through the Web of Science, MEDLINE, Scopus, and Embase databases. The quality of the included studies was evaluated using a 5-item binary scale. The detection rate, location, and classified diameter of the posterior superior alveolar artery were estimated as prevalence values. The diameter of this artery, as well as the distances from the artery to the alveolar crest and sinus floor, were estimated as means with associated 95% confidence intervals.

Results: Thirty-seven studies were enrolled, with 34 of these included in the meta-analysis. The mean detection rate was 79% (range: 72%-84%), and the mean diameter was 1.06±0.05 mm (range: 0.96-1.16 mm). The posterior superior alveolar artery was located intraosseously in 64% of cases. The mean distance of the artery from the alveolar crest was 16.71±0.49 mm (range: 15.75-17.68 mm), while the mean distance from the artery to the sinus floor was 8.85±0.4 mm (range: 8.05-9.64 mm).

Conclusion: According to the findings of this meta-analysis regarding various anatomic characteristics of the posterior superior alveolar artery, severe hemorrhage after damage to this artery during sinus augmentation procedures is not a substantial clinical problem.

Keywords: Cone-Beam Computed Tomography; Hemorrhage; Maxillary Artery; Sinus Floor Augmentation.

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Conflict of interest statement

Conflict of Interest: None

Figures

Fig. 1
Fig. 1. Flow diagram of the inclusion process based on PRISMA protocols.
Fig. 2
Fig. 2. A. Forest plot depicting the pooled prevalence of the detection rate of the posterior superior alveolar artery (PSAA) with associated 95% confidence intervals (CIs), based on the meta-analyzed studies. B. Forest plot depicting the ratio of PSAA detection rates of male to female participants, with associated 95% CIs, from the examined studies.
Fig. 3
Fig. 3. A. Forest plot depicting the pooled mean diameter of the posterior superior alveolar artery (PSAA) with associated 95% confidence intervals (CIs), based on the meta-analyzed studies. B. Forest plot of the mean difference (mean diameter in males - mean diameter in females) of the diameter of the PSAA, with corresponding 95% CIs, from the examined studies.
Fig. 4
Fig. 4. Forest plots of the pooled prevalence of the location of the posterior superior alveolar artery (PSAA) in intraosseous (A), intrasinus (B), and superficial (C) groups, with associated 95% confidence intervals, from the meta-analyzed studies.
Fig. 5
Fig. 5. A. Forest plot depicting the pooled mean distance of the posterior superior alveolar artery (PSAA) from the alveolar crest, with associated 95% confidence intervals (CIs), based on the meta-analyzed studies. B. Forest plot of the mean difference (mean distance in males - mean distance in females) of the distance of the PSAA from the alveolar crest, with corresponding 95% CIs, from the examined studies.
Fig. 6
Fig. 6. A. Forest plot depicting the pooled mean distance of the posterior superior alveolar artery (PSAA) from the sinus floor, with associated 95% confidence intervals (CIs), based on the meta-analyzed studies. B. Forest plot of the mean difference (mean distance in males - mean distance in females) of the distance of the PSAA from the sinus floor, with corresponding 95% CIs, from the examined studies.
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