Evaluation of the blood and nerve supply patterns in the molar region of the maxillary sinus in Japanese cadavers.

The maxillary sinus (MS) in the maxilla bone is located near the orbit, the nasal cavity and the oral cavity; however, the positioning of the constituent bones is complex. The posterior superior alveolar branches of the maxillary artery and nerve are distributed in the lateral wall of the MS. The courses of these blood vessels and nerves are restricted by the morphology of the craniofacial bones, and the landmarks used in dental implant treatment of these courses mainly run along the lateral wall of the MS. In this study, 19 human cadavers with 34 sides of Japanese origin (ranging in age from 59-94 years, mean 77.7 +/- 9.8 years) were prepared for measurement of the MS, the superior alveolar artery and the infraorbital artery using cone beam computed tomography (CBCT). The posterior superior alveolar artery (PSAA) of the lateral wall of the MS can be classified into one of three groups based on the supply pattern. In the greatest number of cadavers, the PSAA ran mainly to the lateral surface of the zone between the superior border of the alveolar foramen and the inferior border of the MS (53.0%, 18/34). In others, the PSAA ran to the zone between the infraorbital foramen and the superior border of the alveolar foramen (17.6%, 6/34); in a third group, the PSAA ran to the zone between the inferior border of the MS and the greater palatine foramen (23.5%, 8/34). The lest of two sides are spread out in this area (5.9%, 2/34). CBCT is the most accurate tool to evaluate important anatomical parameters, such as the distance of the blood supply, for the implant of grafts in the floor of the MS during surgical procedures.