Análise de variações anatômicas neurovasculares da maxila por meio da tomografia computadorizada por feixe cônico

Abstract

The objective of this study was to conduct a cross - sectional retrospective study of the prevalence and characteristics of anatomical variations of neurovascular nature CBCT (cone beam computed tomography) scans indicated for clinical dental procedures. Two papers were elaborated through the data collected in the research, divided according to the regions of the maxilla in which neurovascular channels and their variations were observed. In manuscript 1, pre-maxilla region, the structures observed and studied were: the incisive canal (IC), having as variations the presence of septa in its middle third and the altered caliber and diameter of the canal and its foramen; and the canalis sinuosus (CS), having as its main variation the presence of alveolar extension with palatal emergence or in the alveolar ridge. In manuscript 2, posterior maxillary region, the posterior superior alveolar canal (PSAc) having as its main variation the extension to the alveolar ridge. The data collected were obtained from the CBCT scans of 291 patients. In addition to the structures focused on the study, the other incidental findings pertinent to the maxilla, maxillary sinus and nasal cavity were correlated with detections of anatomical variations, as well as inflammatory and pathological processes observed in the imaging examination. The IC presented septations in 4.12% of the cases and in 22.68% were it was observed changes in the caliber and diameter of the canal and its foramen (variations expected, associated to age and maxillary reabsorption); the CS presented alveolar extension in 17.15% of the cases, with a slight preference for right side unilaterality; PSAc presented alveolar extension in 15.46% of the sample, with a preference for the left side. The sample showed relevant heterogeneity, with 60.48% of the patients in female gender, the age ranged from 5 to 93 years, with 34.36% of the patients between 50 and 59 years old. CBCT has been shown to be an efficient method for locating and exploring these anatomical variations, which, due neurovascular nature, it is required caution in preoperative planning and during surgery because it has the potential for complications. Two diagnostic flow diagrams were elaborated based on the findings with the purpose of creating a support for the interpretation and localization of these anatomical variations in the CBCT examination, being necessary the validation of the same ones in later studies.